Kava-Induced Acute Cutaneous Toxicity: An Increasingly Recognized Characteristic Clinicohistologic Pattern

The document discusses a case of acute cutaneous toxicity believed to be caused by kava ingestion, reinforcing the characteristic clinicohistologic features of such a reaction. A 26-year-old man presented with a cutaneous eruption characterized by diffuse, erythematous, and edematous papules and plaques on his face, neck, upper trunk, and proximal upper extremities after starting to drink kava herbal tea. Histologic examination showed suppurative folliculitis with perifolliculitis and a neutrophilic infiltrate within the hair follicles and sebaceous glands. The patient had mild neutrophilia and transaminitis, indicating systemic involvement. Unlike a previous case that did not respond to prednisone, this patient's condition resolved completely after a 4-day course of oral prednisone and topical hydrocortisone. The document emphasizes the importance of dermatologists being aware of kava-induced cutaneous toxicities and the necessity of inquiring about patients' use of complementary and alternative medicines, given the increasing accessibility of kava and its potential for adverse interactions with prescribed medications.