Diagnosing Acute Kava Dermopathy: A Case Report of a Characteristic Cutaneous Eruption

A 41-year-old woman presented to the emergency department with a widespread pruritic, erythematous eruption following 6 weeks of kava consumption for anxiety and insomnia. The eruption began on the abdomen and progressively involved the chest, upper back and face. Laboratory investigations revealed mild derangement of liver function test results. Skin biopsy results demonstrated folliculocentric inflammation and necrosis of sebaceous glands, consistent with acute kava dermopathy. Kava, a traditional anxiolytic herbal preparation, has been implicated in both chronic and acute cutaneous reactions, including ichthyosiform and sebotropic eruptions. Its active compounds, kavalactones, are hypothesised to provoke a cytotoxic T-cell–mediated response targeting sebaceous glands. This case is notable as it occurred in an Australian woman with no travel history to the Pacific Islands—a region where kava use is prevalent. Moreover, the distinct histopathological findings, rarely documented in the literature, provide valuable diagnostic insight and serve as a visual reference for clinicians encountering this condition.