Pustular eruption after drug exposure: is it pustular psoriasis or a pustular drug eruption?

Generalized pustular eruptions with fever present a diagnostic challenge. A history of preceding drug exposure, and rapid disappearance of the eruption after the drug is stopped, suggest a drug-induced aetiology rather than pustular psoriasis. We describe and evaluate the clinical and histological features of four patients who developed a generalized pustular eruption following drug administration. The history of preceding drug exposure and the presence of a variable number of eosinophils in the inflammatory infiltrate in the lesions of these cases suggested that the generalized pustular eruptions were drug-induced.