Itraconazole-associated purpuric drug eruption: a rare adverse effect of a commonly prescribed drug

Purpuric drug eruption (PDE) is a rare drug reaction characterized by purpuric macules, papules and confluent plaques predominantly on the lower extremities. The drugs reported to induce PDE are epidermal growth factor receptor inhibitors, ketoconazole, acetylsalicylic acid, penicillin, sulfonamides, indomethacin, lenalidomide, linezolid and vancomycin. Drug-induced thrombocytopenia, platelet dysfunction and direct toxic effects of the drug on the capillary wall leading to increased capillary fragility are the proposed aetiologies. There is only a single report of itraconazole-induced PDE in the literature to date. We herein present a case of 57-year-old woman with PDE due to itraconazole.