A Case of Cycloserine-Induced Lichenoid Drug Eruption Supported by the Lymphocyte Transformation Test

Kim, Jakyoung; ShinYoung, Park; Jung, Chul Min; Oh, Chang Wug; Kwon, Jae Woo

doi:10.4168/aair.2017.9.3.281

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…Other culprit drugs are listed in Table S1. Regarding anti‐infectious treatments (tetracyclines, ß‐lactam antibiotics, sulfonamides or anti‐tubercular drugs) were a reported cause of LDE in 17 (5.3%) cases 63–70 antiviral agents for hepatitis treatment were associated with LDE in 7 (2.2%) cases 71–76 and the antimycotic drug terbinafine in three cases (0.9%) 77–81 …”

Section: Resultsmentioning

confidence: 99%

“…Other culprit drugs are listed in Table S1. Regarding anti-infectious treatments (tetracyclines, ß-lactam antibiotics, sulfonamides or anti-tubercular drugs) were a reported cause of LDE in 17 (5.3%) cases [63][64][65][66][67][68][69][70] antiviral agents for hepatitis treatment were associated with LDE in 7 (2.2%) cases [71][72][73][74][75][76] and the antimycotic drug terbinafine in three cases (0.9%). [77][78][79][80][81] Furthermore, we identified six cases (1.9%) of LDE caused by beta-blockers 77,[82][83][84][85][86] and 7 (2.2%) cases caused by statins.…”

Section: Culprit Medicationsmentioning

confidence: 99%

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Cutaneous lichenoid drug eruptions: A narrative review evaluating demographics, clinical features and culprit medications

Maul

Guillet

Oschmann

et al. 2023

Acad Dermatol Venereol

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Cutaneous lichenoid drug eruptions (LDE) are adverse drug reactions (ADR) characterized by symmetric, erythematous, violaceous papules reminiscent but rarely fully characteristic of lichen planus (LP). We aimed to analyse the literature describing cases of LDE within the last 20 years to provide additional insight into culprit drugs, typical latency to onset of the eruption, the spectrum of clinical presentations, severity and management. A literature search was conducted in MEDLINE between January 2000 and 27 January 2021. The keywords ‘lichenoid drug rash’ and ‘lichenoid drug eruption’ were used. Cases were included if LDE diagnosis was made, and culprit drugs were identified. A total of 323 cases with LDE were identified from 163 published case reports and studies. The mean patient age was 58.5 years (1 month to 92 years), and 135 patients (41.8%) were female. Checkpoint inhibitors (CKI) were the most frequently reported culprit drugs (136 cases; 42.1%), followed by tyrosine kinase inhibitors (TKI) (39 cases; 12.0%) and anti‐TNF‐α‐monoclonal antibodies (13 cases; 4.0%). The latency between initiation of the drug and manifestation was 15.7 weeks (range: 0.1–208 weeks). After discontinuing the culprit drug, the median time to resolution was 14.2 weeks (range: 0.71–416 weeks). One hundred thirty‐six patients (42.1%) were treated with topical, and 54 patients (16.7%) with systemic glucocorticoids. Overall, we conclude that, albeit rare, LDE is challenging to diagnose ADR induced by mostly CKI, TKI, and biologics. Treatment modalities resemble that of lichen planus, and the culprit drugs had to be discontinued in only 26%, which is low compared with other types of adverse drug reactions. This is probably due to the low risk of aggravation (e.g. toxic epidermal necrolysis) if the drug is continued and the benefit/risk ratio favouring the drug, as is often the case in cancer therapy.

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Section: Resultsmentioning

confidence: 99%

Section: Culprit Medicationsmentioning

confidence: 99%

Cutaneous lichenoid drug eruptions: A narrative review evaluating demographics, clinical features and culprit medications

Maul

Guillet

Oschmann

et al. 2023

Acad Dermatol Venereol

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“… Jakyoung Kim, Shinyoung Park, Chul Min Jung et al . (2017)[ 6 ]: A 38-year-old male suffering from pulmonary tuberculosis, who had been undergoing ATT treatment for four months, was hospitalized owing to generalized pruritus. During the first two months of treatment, he was administered isoniazid, rifampin, ethambutol, and pyrazinamide, following which he received second-line anti-TB drugs such as ethambutol, levofloxacin, and cycloserine.…”

Section: Introductionmentioning

confidence: 99%

Antitubercular drug-induced lichen planus: A case study with a mini literature review

Shanmukhappa,

John,

Kevalramani

et al. 2024

Journal of Family Medicine and Primary Care

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Introduction: Drug-induced lichen planus is a cutaneous adverse effect that manifests as a systemic eruption of flat-topped, erythematous, or violaceous papules resembling lichen planus on the trunk and extremities. Although antitubercular therapy has been linked to cutaneous hypersensitivity reactions, the literature on such cases is scarce. Here, we present a case to contribute to this field, reporting on its presentation and management, and reviewing previous case studies. Case Report: Our patient, a 63-year-old male, presented with black pigmented patches on the skin, having been diagnosed with pulmonary tuberculosis and on antitubercular therapy for the past two months. A diagnosis of ATT-induced lichen planus was made, and all ATT was stopped. The patient was treated with antihistamines, apremilast, tacrolimus, and corticosteroids, and rechallenge of each drug was performed consecutively. No new lesions appeared after rechallenge with isoniazid and rifampicin. However, ethambutol was not reintroduced due to strong suspicion, by exclusion, that it was the offending agent, whereas on rechallenge with isoniazid and rifampicin, the patient’s skin lesions gradually improved with eventual resolution of hyperpigmentation. Discussion and Conclusion: Lichenoid drug eruptions are characterized by type IV hypersensitivity reactions, and rechallenge is required to ensure safer treatment since the risk of disseminated and multi-drug-resistant tuberculosis increases with the cessation of antitubercular therapy.

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“…Lichenoid drug eruption (LDE) due to first-line anti-tubercular therapy (ATT) (Ethambutol, Isoniazid, p-Aminosalicylic acid, and Streptomycin) is known,[ 1 ] however, it occurs rarely after second-line ATT with the implicated drug in the literature being Cycloserine. [ 2 3 ] Here, we describe a case of LDE due to second-line ATT which progressed into erythroderma.…”

mentioning

confidence: 99%

“…It being the only second-line ATT drug reported to cause LDE. [ 2 3 ] Hence, the ATT drugs were stopped and systemic steroids in a tapering dose were administered following which the erythema, edema, and scaling subsided. The violaceous papules and plaques started resolving with post-inflammatory hyperpigmentation.…”

mentioning

confidence: 99%

Lichenoid Drug Eruption Progressing into Erythroderma in A Case of Cervical Scrofuloderma Due to Multi Drug-Resistant Tuberculosis

Sodhi

Kura

Chavhan

et al. 2022

Indian Journal of Dermatology

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A Case of Cycloserine-Induced Lichenoid Drug Eruption Supported by the Lymphocyte Transformation Test

Cited by 6 publications

References 16 publications

Cutaneous lichenoid drug eruptions: A narrative review evaluating demographics, clinical features and culprit medications

Cutaneous lichenoid drug eruptions: A narrative review evaluating demographics, clinical features and culprit medications

Antitubercular drug-induced lichen planus: A case study with a mini literature review

Lichenoid Drug Eruption Progressing into Erythroderma in A Case of Cervical Scrofuloderma Due to Multi Drug-Resistant Tuberculosis

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