Eszopiclone-Induced Drug Eruption: A Case Report

Eszopiclone is a non-benzodiazepine hypnotic widely used for the treatment of insomnia.Although noncutaneous adverse effects are well recognized, cutaneous drug reactions associated with eszopiclone have not previously been reported.A 49-year-old Japanese man developed multiple asymptomatic scaly erythematous papules and plaques on the trunk and upper extremities approximately two months after initiation of eszopiclone, escitalopram, and ethyl loflazepate.The eruption persisted despite replacement of escitalopram and ethyl loflazepate.Histopathological examination revealed focal parakeratosis, mild spongiosis, basal vacuolar degeneration, and superficial perivascular lymphocytic infiltration with scattered eosinophils.A lymphocyte stimulation test showed a stimulation index of 2.0 for eszopiclone, whereas those for sertraline and diazepam were below the institutional diagnostic threshold.The eruption resolved almost completely within two months after discontinuation of eszopiclone and treatment with topical corticosteroids, without recurrence.Clinicians should consider eszopiclone as a potential causative drug in patients presenting with cutaneous eruptions while receiving multiple psychotropic medications.