Diagnostic challenge of an untypical cutaneous drug reaction from modafinil

Key Clinical Message Modafinil used for narcolepsy caused an atypical adverse reaction, as itchy acneiform lesions, subcutaneous nodules and superficial skin wounds after 2 years of use. After extensive examinations for 5 years, modafinil was discontinued, and the healing process began in 3 weeks with completion in 1.5 years.