Sex: M
Vaccine: PPV
Symptoms: Skin discolouration, Skin exfoliation, Vitamin B12
Clinical narrative: On 3/21/2019 the patient began to experience muscle pain in his arms and severe dermatitis on the palms of his hands.; The palms of the patient's hands turned white and the patient developed "non-itchy scaling" on the palms of his hands.; The palms of the patient's hands turned white and the patient developed "non-itchy scaling" on the palms of his hands. The scaling then began to "slough off". The pharmacist states that the symptoms of scaling and sloughing possibly involved the sol; On 3/21/2019 the patient began to experience muscle pain in his arms and severe dermatitis on the palms of his hands.; the patient's medical records has "PNEUMOVAX" listed under the drug allergy section.; This spontaneous report was received from a pharmacist concerning an approximately 81-year-old male patient.  The patient's concurrent conditions included hypothyroidism, diverticulitis, lactose intolerance, gastrooesophageal reflux disease, previously drug reactions to levothyroxine, iodine and food allergy to shellfish. The patient's medical history included eczema and pruritus. The patient did not experience any adverse event with infliximab-dyyb (INFLECTRA). Concomitant therapies included prednisone, mesalamine, tramadol hydrochloride, balsalazide disodium and an unspecified thyroid medication (1/4 grain).     On an unspecified date in 2015, the patient's medical records indicated that he received one dose of pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) (strength, dose, frequency, route of admiistration, lot number and expiration date were not provided) as prophylaxis. It was reported that in the patient's medical records, pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) was listed under the drug allergy section (drug hypersensitivity) but the records did not have information regarding the reaction that the patient experienced. On an unspecified date, the patient started therapy with infliximab-dyyb (INFLECTRA) as treatment for ulcerative colitis and on an unspecified date, therapy with infliximab-dyyb (INFLECTRA) was discontinued. The patient was switched to infliximab-abda (RENFLEXIS). On 19-MAR-2019, the patient started therapy with infliximab-abda (RENFLEXIS) 100 milligram injection, dose 500 mg in 250 ml saline infused over 2 hours (frequency not provided), intravenously, (lot number and expiration date were not provided) as treatment for ulcerative colitis. This was the only reported dose of infliximab-abda (RENFLEXIS).   On 21-MAR-2019, the patient began to experience muscle pain in his arms (myalgia) and severe dermatitis on the palms of his hands (hand dermatitis). The palms of the patient's hands turned white (skin discolouration). He developed a "non-itchy scaling" that began to "slough off" (skin exfoliation). It was reported that the "scaling" and sloughing symptoms could possibly involve the soles of the patient's feet. On an unspecified date, laboratory tests including complete blood count (CBC), comprehensive metabolic panel (CMP), vitamin B12 level and C-reactive protein (CRP) level were performed (results not provided). On 28-MAR-2019, the patient sought medical attention because of the events, and it was decided to discontinue theraphy with infliximab-abda (RENFLEXIS). No treatment was prescribed for the patient's symptoms and on an unspecified date in April 2019 (also reported as "at least 2 weeks" after the onset of symptoms), the patient recovered from the events.  The causal relationship between drug hypersensitivity and pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) was related. The occurrence of the events of myalgia, hand dermatitis, skin discolouration and skin exfoliation was linked to the other suspect therapy infliximab-abda (RENFLEXIS), but the relatedness was not reported.