CPC13: Two cases of trimethoprim‐induced drug reaction with eosinophilia and systemic symptoms

Abstract

ulators, chemotherapy and radiotherapy. Thalidomide was considered for this patient, having been used successfully in other reported cases. As a talented harpist, the patient was concerned about peripheral neuropathy and therefore opted for MTX. The prognosis of LCH varies depending on several factors: age at diagnosis, organ involvement and severity of disease. Patients remain under regular surveillance with repeat imaging owing to the risk of widespread disease. Whole-body positron emission tomography scan is the gold-standard imaging modality for disease surveillance (Wieland R, Flanagan J, Everett E, Mount S. Langerhans cell histiocytosis limited to the female genital tract: a review of literature with three additional cases. Gynecol Oncol Rep 2017; 22: 4–8). This case is particularly important as it highlights the difficulty in recognizing this condition and the potential delay in diagnosis, leading to considerable physical and psychological impact for the patient. We urge all clinicians to consider vulval LCH as a differential diagnosis for recalcitrant vulval ulceration, pain and itching, which, in turn, will minimize the risk of mortality associated with this disease.