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United States Food and Drug Administration , Humanos , Estados Unidos/epidemiología , Estudios Transversales , Masculino , Femenino , Persona de Mediana Edad , Sistemas de Registro de Reacción Adversa a Medicamentos/estadística & datos numéricos , Hipoglucemiantes/efectos adversos , Hipoglucemiantes/administración & dosificación , Péptido 1 Similar al Glucagón/agonistas , Péptido 1 Similar al Glucagón/efectos adversos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Receptor del Péptido 1 Similar al Glucagón/agonistas , Anciano , Liraglutida/efectos adversos , Liraglutida/uso terapéutico , Exenatida/efectos adversos , Exenatida/administración & dosificación , Adulto , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/epidemiologíaRESUMEN
Papulopustular eruptions are the most common dermatologic side effect of epidermal growth factor receptor inhibitor (EGFRI) therapy. Topical corticosteroids and oral tetracyclines are frequently used to manage these eruptions, though these treatments are limited by their adverse effects and efficacy. Results from preclinical studies suggest a role for topical aprepitant (HT-001) in the treatment of EGFRI-induced skin toxicities. Herein a case of EGFRI-induced papulopustular eruption with rapid treatment response to topical aprepitant (HT-001) 2% cream is described and the literature reviewed. J Drugs Dermatol. 2024;23(9):e173-e174. doi:10.36849/JDD.8617.
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Aprepitant , Erupciones por Medicamentos , Receptores ErbB , Morfolinas , Humanos , Aprepitant/administración & dosificación , Receptores ErbB/antagonistas & inhibidores , Morfolinas/administración & dosificación , Morfolinas/efectos adversos , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/diagnóstico , Erupciones por Medicamentos/tratamiento farmacológico , Erupciones por Medicamentos/patología , Femenino , Masculino , Administración Cutánea , Resultado del Tratamiento , Antineoplásicos/efectos adversos , Antineoplásicos/administración & dosificación , Persona de Mediana EdadRESUMEN
The present case series examined five instances of psoriasiform drug eruption diagnosed between 2014 and 2022 at the study site and 23 cases of drug eruption manifesting psoriasiform lesions which had been reported between 1986 and 2022. The causative drug, distribution of the skin eruptions, clinical latency to eruption, treatment course, and histopathological findings were investigated. The most common causative agents were calcium channel blockers (CCB) (64.5%). Of the 28 cases of psoriasiform drug eruption for which details of the eruption sites were reported, 46.4% occurred on the face, which was slightly higher than the usual distribution of psoriasis. CCB were responsible for 80.0% of the cases of facial skin rash. The mean time from the administration of the suspected drug to eruption onset was 25.0 months (range: 0.5-120 months; median: 13.0 months). In all the cases, the skin rash improved after the causative drug was discontinued. CCB were the most common causative agent, and the eruptions more commonly occurred on the face than in normal psoriasis, suggesting that it is especially important to confirm whether there is a history of CCB administration in psoriasis patients with extensive, facial skin eruptions.
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Bloqueadores de los Canales de Calcio , Erupciones por Medicamentos , Psoriasis , Humanos , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/patología , Psoriasis/inducido químicamente , Psoriasis/tratamiento farmacológico , Femenino , Masculino , Persona de Mediana Edad , Adulto , Anciano , Bloqueadores de los Canales de Calcio/efectos adversos , Exantema/inducido químicamente , Exantema/patologíaAsunto(s)
Erupciones por Medicamentos , Tiohidantoínas , Humanos , Masculino , Tiohidantoínas/efectos adversos , Femenino , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/patología , Persona de Mediana Edad , Anciano , Biopsia , Piel/patología , Piel/efectos de los fármacos , AdultoRESUMEN
Importance: Serious cutaneous adverse drug reactions (cADRs) are potentially life-threatening drug hypersensitivity reactions involving the skin and internal organs. Antibiotics are a recognized cause of these reactions, but no studies have compared relative risks across antibiotic classes. Objectives: To explore the risk of serious cADRs associated with commonly prescribed oral antibiotics, and to characterize outcomes of patients hospitalized for them. Design, Setting, and Participants: Nested case-control study using population-based linked administrative datasets among adults aged 66 years or older who received at least 1 oral antibiotic between 2002 and 2022 in Ontario, Canada. Cases were those who had an emergency department (ED) visit or hospitalization for serious cADRs within 60 days of the prescription, and each case was matched with up to 4 controls who did not. Exposure: Various classes of oral antibiotics. Main Outcomes and Measures: Conditional logistic regression estimate of the association between different classes of oral antibiotics and serious cADRs, using macrolides as the reference group. Results: During the 20-year study period, we identified 21â¯758 older adults (median age, 75 years; 64.1% female) who had an ED visit or hospitalization for serious cADRs following antibiotic therapy and 87â¯025 matched controls who did not. In the primary analysis, sulfonamide antibiotics (adjusted odds ratio [aOR], 2.9; 95% CI, 2.7-3.1) and cephalosporins (aOR, 2.6; 95% CI, 2.5-2.8) were most strongly associated with serious cADRs relative to macrolides. Additional associations were evident with nitrofurantoin (aOR, 2.2; 95% CI, 2.1-2.4), penicillins (aOR, 1.4; 95% CI, 1.3-1.5), and fluoroquinolones (aOR, 1.3; 95% CI, 1.2-1.4). The crude rate of ED visits or hospitalization for cADRs was highest for cephalosporins (4.92 per 1000 prescriptions; 95% CI, 4.86-4.99) and sulfonamide antibiotics (3.22 per 1000 prescriptions; 95% CI, 3.15-3.28). Among the 2852 case patients hospitalized for cADRs, the median length of stay was 6 days (IQR, 3-13 days), 9.6% required transfer to a critical care unit, and 5.3% died in the hospital. Conclusion and Relevance: Commonly prescribed oral antibiotics are associated with an increased risk of serious cADRs compared with macrolides, with sulfonamides and cephalosporins carrying the highest risk. Prescribers should preferentially use lower-risk antibiotics when clinically appropriate.
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Antibacterianos , Erupciones por Medicamentos , Macrólidos , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Administración Oral , Antibacterianos/efectos adversos , Antibacterianos/administración & dosificación , Estudios de Casos y Controles , Cefalosporinas/efectos adversos , Cefalosporinas/administración & dosificación , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Fluoroquinolonas/administración & dosificación , Fluoroquinolonas/efectos adversos , Hospitalización/estadística & datos numéricos , Macrólidos/administración & dosificación , Macrólidos/efectos adversos , Nitrofurantoína/administración & dosificación , Nitrofurantoína/efectos adversos , Ontario/epidemiología , Penicilinas/administración & dosificación , Penicilinas/efectos adversos , Sulfonamidas/administración & dosificación , Sulfonamidas/efectos adversos , Medición de Riesgo/estadística & datos numéricosRESUMEN
Over the past decade, treatment with immune checkpoint inhibitors (ICI) has been implemented in cancer treatment. It has led to a significant improvement in the prognosis for many types of cancer. ICIs work by inducing the body's immune response against cancer cells. Unfortunately, they can also cause immune-related adverse events in most organ systems, with skin-related adverse events being among the most common. This review provides an overview of existing evidence and clinical experience regarding managing dermatological adverse events associated with ICIs.
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Erupciones por Medicamentos , Inhibidores de Puntos de Control Inmunológico , Humanos , Inhibidores de Puntos de Control Inmunológico/efectos adversos , Erupciones por Medicamentos/etiología , Neoplasias/tratamiento farmacológicoAsunto(s)
Erupciones por Medicamentos , Pruebas Intradérmicas , Metilprednisolona , Humanos , Metilprednisolona/uso terapéutico , Metilprednisolona/administración & dosificación , Erupciones por Medicamentos/diagnóstico , Erupciones por Medicamentos/etiología , Inyecciones Intraarticulares , Femenino , Masculino , Persona de Mediana EdadRESUMEN
Skin toxicities caused by epidermal growth factor receptor tyrosine kinase inhibitors can affect patient quality of life and lead to treatment adjustments, including dose reduction or discontinuation. This retrospective study aimed to profile skin toxicities and their impact on treatment adjustments. A total of 288 non-small cell lung cancer patients treated with first-, second-, or third-generation epidermal growth factor receptor tyrosine kinase inhibitors were included. Skin toxicities, including papulopustular rash, xerosis, paronychia, and pruritus, were assessed based on medical records, and their severity was evaluated based on the required dermatological intervention. Papulopustular rash was the most common toxicity (74.3%), followed by pruritus (61.1%), xerosis (52.4%), and paronychia (39.6%). Papulopustular rash was more common in males and more severe in younger patients. Papulopustular rash was more prevalent in patients treated with first- and second-generation epidermal growth factor receptor tyrosine kinase inhibitors, while paronychia was notably frequent for the second-generation epidermal growth factor receptor tyrosine kinase inhibitors. Second-generation epidermal growth factor receptor tyrosine kinase inhibitors frequently caused multiple skin toxicities. Importantly, skin toxicities led to epidermal growth factor receptor tyrosine kinase inhibitor treatment adjustments in 26.7% of cases, with second-generation epidermal growth factor receptor tyrosine kinase inhibitors demonstrating higher adjustment rates. Papulopustular rash and paronychia were the main causes of treatment adjustments, with even mild paronychia being linked to treatment adjustments. Effective management of skin toxicities is essential for optimizing treatment outcomes in patients receiving epidermal growth factor receptor tyrosine kinase inhibitors.
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Carcinoma de Pulmón de Células no Pequeñas , Erupciones por Medicamentos , Receptores ErbB , Neoplasias Pulmonares , Inhibidores de Proteínas Quinasas , Humanos , Masculino , Neoplasias Pulmonares/tratamiento farmacológico , Femenino , Estudios Retrospectivos , Inhibidores de Proteínas Quinasas/efectos adversos , Receptores ErbB/antagonistas & inhibidores , Anciano , Persona de Mediana Edad , Erupciones por Medicamentos/etiología , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Antineoplásicos/efectos adversos , Anciano de 80 o más Años , Adulto , Resultado del Tratamiento , Índice de Severidad de la Enfermedad , Factores de Riesgo , Paroniquia/inducido químicamenteRESUMEN
A generalized fixed drug eruption (FDE) is an uncommon but potentially dangerous reaction to medication. In this case series, we present 1 patient with a generalized FDE and 2 patients with generalized bullous FDE that resolved with cyclosporine, though 1 patient required close monitoring in the intensive care unit. Immediate acceleration of care upon development and recognition of generalized bullous FDE is essential, as the mortality rate is similar to Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN).
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Erupciones por Medicamentos , Humanos , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/diagnóstico , Masculino , Femenino , Persona de Mediana Edad , Ciclosporina/administración & dosificación , Ciclosporina/efectos adversos , Síndrome de Stevens-Johnson/terapia , Síndrome de Stevens-Johnson/diagnóstico , Síndrome de Stevens-Johnson/etiología , Anciano , Adulto , Atención Ambulatoria , Inmunosupresores/efectos adversos , Inmunosupresores/administración & dosificaciónRESUMEN
BACKGROUND: MEK inhibitors cause a wide spectrum of mucocutaneous toxicities which can delay or interrupt life-saving therapy. PURPOSE: To summarize the morphology, incidence, and clinical presentation of mucocutaneous toxicities from MEK inhibitors via a scoping review of the literature. METHODS: We conducted a scoping review of the published literature, including clinical trials, retrospective and prospective studies, reviews, and case reports and series. All included literature was analyzed by a panel of pediatric and adult oncodermatologists. RESULTS: Of 1626 initial citations, 227 articles met final inclusion criteria. Our review identified follicular reactions, ocular toxicities, xerosis, eczematous dermatitis, edema, and paronychia as the most common mucocutaneous side effects from MEK inhibitor therapy. Grade 1 and 2 reactions were the most prevalent and were typically managed while continuing treatment; however, grade 3 toxicities requiring dose reductions or treatment interruptions were also reported. CONCLUSION: Mucocutaneous toxicities to MEK inhibitor therapy are common and most often mild in severity. Early recognition and treatment can mitigate disruptions in oncologic therapy.
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Inhibidores de Proteínas Quinasas , Humanos , Inhibidores de Proteínas Quinasas/efectos adversos , Antineoplásicos/efectos adversos , Neoplasias/tratamiento farmacológico , Índice de Severidad de la Enfermedad , Erupciones por Medicamentos/etiologíaRESUMEN
A unique dermatopathology incident arose after administration of the mRNA-1273 SARS-CoV-2 (Moderna) vaccine. Specifically, a transient purpuric interface dermatitis occurred 5 days post-second vaccine with the presentation of erythematous papules with erythema multiforme-type findings. A patient developed purpuric interface dermatitis with micro-vesiculation post-vaccination which ultimately resolved without sequelae.
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Vacunas contra la COVID-19 , Eritema Multiforme , Humanos , Eritema Multiforme/inducido químicamente , Eritema Multiforme/patología , Vacunas contra la COVID-19/efectos adversos , Vacuna nCoV-2019 mRNA-1273/efectos adversos , Femenino , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/patología , Masculino , COVID-19/prevención & control , Persona de Mediana Edad , Púrpura/etiología , Púrpura/patologíaRESUMEN
BACKGROUND: In the Nordic European Countries, cancer is the leading cause of death. The last decade has brought revolutionizing cancer treatments including immune checkpoint inhibitors (ICIs). Patients on ICIs have a high risk of developing cutaneous immune-related adverse events. Treating these side effects is of high importance to improve patient's quality of life (QoL) and continue the anti-cancer treatment. METHODS: The Nordic European Cutaneous Oncodermatology Management (NECOM) project develops tools to prevent and treat cancer therapy-related cutaneous adverse events (cAEs). The first 2 NECOM papers presented various cAEs and skincare regimens involving hygiene, moisturization, sun protection, and camouflage products for preventing and managing cAEs. The NECOM 3 practical algorithm was on the prevention and treatment of acute radiation dermatitis. This NECOM 4 practical algorithm is intended to prevent and manage cutaneous immunotherapy-related adverse events (cirAEs), improving cancer patients' QoL and outcomes. RESULTS: The NECOM advisors discussed the results of a systematic literature review and obtained consensus on the evidence and expert opinion-based practical algorithm for cirAEs to support all healthcare providers treating cancer patients in the Nordic European Countries. The algorithm starts with a simple skincare regimen of cleansing, moisturizing, and protection, followed by the exclusion of severe cutaneous adverse reactions, and then specific interventions to treat the most common cirAEs (pruritus, maculopapular eruption, eczematous eruption, psoriasis, lichenoid eruption, and bullous eruption). CONCLUSIONS: CirAEs are the most common side effects induced by ICIs and may lead to cancer treatment interruption or even discontinuation. Patient education on the prevention of cirAEs using a skincare regimen and treatment recommendations given in the NECOM 4 algorithm may help prevent and manage cirAEs and improve the QoL and outcome of patients receiving ICIs. J Drugs Dermatol. 2024;23:8(Suppl 2):s4-10.
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Algoritmos , Inhibidores de Puntos de Control Inmunológico , Neoplasias , Calidad de Vida , Cuidados de la Piel , Humanos , Neoplasias/tratamiento farmacológico , Neoplasias/terapia , Inhibidores de Puntos de Control Inmunológico/efectos adversos , Inhibidores de Puntos de Control Inmunológico/administración & dosificación , Cuidados de la Piel/métodos , Cuidados de la Piel/efectos adversos , Supervivientes de Cáncer , Inmunoterapia/efectos adversos , Inmunoterapia/métodos , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/diagnóstico , Erupciones por Medicamentos/prevención & control , Erupciones por Medicamentos/terapia , Países Escandinavos y NórdicosAsunto(s)
Anticuerpos Monoclonales Humanizados , Neoplasias Cutáneas , Humanos , Anticuerpos Monoclonales Humanizados/efectos adversos , Anticuerpos Monoclonales Humanizados/uso terapéutico , Masculino , Femenino , Anciano , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/patología , Persona de Mediana Edad , Exantema/inducido químicamente , Exantema/patología , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/diagnóstico , Erupciones por Medicamentos/patología , Síndrome de Sézary/tratamiento farmacológico , Micosis Fungoide/tratamiento farmacológico , Micosis Fungoide/patologíaAsunto(s)
Conservadores de la Densidad Ósea , Difosfonatos , Pamidronato , Ácido Zoledrónico , Humanos , Ácido Zoledrónico/efectos adversos , Conservadores de la Densidad Ósea/efectos adversos , Difosfonatos/efectos adversos , Pamidronato/efectos adversos , Femenino , Pruebas Cutáneas , Imidazoles/efectos adversos , Reacciones Cruzadas , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/diagnóstico , Anciano , Persona de Mediana EdadAsunto(s)
Vacunas contra la COVID-19 , Erupciones por Medicamentos , Polietilenglicoles , Humanos , Polietilenglicoles/efectos adversos , Vacunas contra la COVID-19/efectos adversos , Erupciones por Medicamentos/etiología , Femenino , Masculino , COVID-19/prevención & control , Persona de Mediana EdadRESUMEN
BACKGROUND: Cases of psoriasis associated with Tocilizumab (TCZ) are scarce. OBJECTIVE: To describe a new case of TCZ-associated psoriasis and to perform a case-based review of similar cases. METHODS: We searched Medline/Pubmed, Embase, Scopus, Web of Science, and Directory of Open Access Journals databases using the terms « Tocilizumab ¼ and « Psoriasis ¼ in the French and English literature. RESULTS: We report a 70-year-old woman with a history of Rheumatoid Arthritis who developed Infliximab-induced plaque psoriatic eruption of the soles and palms, that resolved after Infliximab interruption, then relapsed after TCZ relay, and eventually resolved after TCZ interruption. Including our case, we identified 16 cases of TCZ-induced psoriatic eruption. Three (21%) out of 14 patients had a history of cutaneous psoriasis - data were not available for 2 patients. Eight (50%) patients had previously received TNFα antagonists. TCZ was stopped for 10 patients and continued for 4 patients. For the 2 remaining patients, the interval between two injections of TCZ was shortened. All the patients with available follow-up data had an improvement of the eruption within 4 weeks. CONCLUSION: To conclude, in case of TCZ-induced psoriatic eruption and in light of the published cases, we suggest using topical steroids and reassessing the patient 4 weeks later. If no healing is obtained, we suggest stopping TCZ, and treating the underlying disease with another drug. When no other drug is available, while waiting for more data regarding the value of IL-6 levels, it can be discussed to increase TCZ regimen, as it has been successful for 2 authors. Efficacy assessment of the chosen attitude should not take place before 4 weeks.
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Anticuerpos Monoclonales Humanizados , Artritis Reumatoide , Psoriasis , Humanos , Femenino , Anticuerpos Monoclonales Humanizados/efectos adversos , Anciano , Psoriasis/inducido químicamente , Psoriasis/tratamiento farmacológico , Artritis Reumatoide/tratamiento farmacológico , Infliximab/efectos adversos , Infliximab/uso terapéutico , Erupciones por Medicamentos/etiología , Erupciones por Medicamentos/tratamiento farmacológico , Antirreumáticos/efectos adversos , Resultado del TratamientoRESUMEN
Traditional herbs have a history of clinical use in anti-fatigue. However, several adverse effects of herbs have been identified. Pityriasis rosea-like eruption (PR-LE) is a rare cutaneous complication of herbs. To the best of our knowledge, there have been few reports of PR-LE following herbs. Here, we described a case of PR-LE that developed 6 days after taking anti-fatigue herbs. After the 17 days of stopping Aconitum carmichaelii Debx and Panax Ginseng, it notably faded. So, when anti-fatigue herbs being authorized for fatigue use, monitoring for potential adverse effects is necessary.