Rara Nabelo, Arga Setyo Adji, Johan Antiono Chandra, Setya Haksama
Background. Erythroderma is a rare but serious dermatologic emergency that is often drug-induced and poses a greater risk in HIV-positive individuals due to altered immune responses. Case report. A 47-year-old HIV-positive male developed diffuse erythema and scaling involving more than 90% of the body surface area after starting a tenofovir–lamivudine–dolutegravir regimen. A presumptive diagnosis of dolutegravir-induced erythroderma was made based on the temporal association. Differential diagnoses included erythrodermic psoriasis, eczema flare, and Sézary syndrome. No skin biopsy, peripheral blood smear, or immunologic testing was performed due to clinical considerations. Management included immediate drug withdrawal, topical emollients and corticosteroids, systemic antihistamines, fluid therapy, and adjustment of antiretroviral therapy. The patient showed progressive clinical improvement during follow-up after discontinuation of the suspected agent. Conclusions. Clinicians should maintain vigilance for drug-induced erythroderma in HIV-infected individuals, particularly following antiretroviral therapy modification, as early recognition and prompt intervention are essential to prevent severe complications. © 2025, Amaltea Medical Publishing House. All rights reserved.
Airlangga University, Surabaya, Indonesia; Faculty of Medicine, Widya Mandala Catholic University, Surabaya, Indonesia; Health Administration and Policy Department, Airlangga University, Surabaya, Indonesia
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