A Rare Psoriasis Drug Eruption Induced by Levetiracetam: A Case Study from Saudi Arabia

Saima Kashif, Salihah Al-Mani and Nalah Almani

Background and Objective: Drug-induced psoriasis, a rare adverse effect of certain medications, involves the onset or exacerbation of psoriatic symptoms triggered by pharmacological agents. The exact mechanisms underlying the development of psoriasis in response to these medications remain unclear, although hypotheses include drug-induced alterations in immune function and inflammatory pathways. Materials and Methods: A 40 years old Saudi female patient, with a history of bronchial asthma and newly diagnosed idiopathic epilepsy is under the treatment of levetiracetam 500 mg PO bid. The patient visited the dermatology clinic of the Armed Forces Hospital, Southern Region, Saudi Arabia, suffering from generalized body itching. Laboratory blood analysis and a hepatic investigation were performed. Results: The microscopic analysis showed focal parakeratosis with degenerated materials and neutrophilic aggregates, minimal epidermal hyperplasia, subtle exocytosis and basal vasculopathy. Also, mild perivascular lymphocytic infiltrates were noticed in the dermis layer. The presence of atypical features (basal vasculopathy and spongiosis) is a significant point towards possible drug-induced psoriasis. Conclusion: Psoriasis might be a comorbid symptom induced as a secondary side effect of the epilepsy drug’s (levetiracetam) interaction with the immune system. Further investigations might be required to investigate the mechanism of levetiracetam-induced psoriasis.

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