Pustular‐type drug‐induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms due to carbamazepine with systemic muscle involvement

Drug‐induced hypersensitivity syndrome ( DIHS )/drug reaction with eosinophilia and systemic symptoms ( DRESS ) is a severe reaction usually associated with maculopapular eruptions and systemic involvement. Here we report the first case, to our knowledge, of DIHS / DRESS due to carbamazepine with acute generalized pustular bacterid‐like ( AGPB ‐like) eruptions and skeletal muscle involvement. Reviewing our case and the published work, we discuss pustular‐type DIHS / DRESS which, in most cases, involves acute generalized exanthematous pustulosis ( AGEP )‐like skin eruptions in response to carbamazepine. Pustular eruptions may appear in relatively few cases of DIHS / DRESS , in particular, when the causative drug is carbamazepine and, even in cases of intractable pustular bacterid‐like eruptions, a reaction to a drug should be suspected. Skeletal muscle involvement may be associated with DIHS / DRESS as one of its systemic manifestations.