Pompholyx as a Side Effect of Intravenous Immunoglobulin (IVIg)

A 43-year-old woman presented with a two-week history of progressive peripheral sensory neuropathy. Despite extensive investigations no cause had been identified. She has a background history of hepatitis C (treated successfully in 2018) and prior intravenous drug use. She was commenced on intravenous immunoglobulin (IVIg) at a dose of 400mg/kg daily for 5 days as a trial of treatment for her sensory peripheral neuropathy under the guidance of neurology. After receiving her third dose of IVIg she developed a discrete intensely pruritic vesicular rash on her palms and fingers bilaterally consistent with pompholyx. No other areas were affected. She was started on clobetasol proprionate 0.05% ointment once daily and advised to wash with soap substitutes and use non-fragranced emollients daily.