Azathioprine induced anagen effluvium: a rare case report

Sharma, Saurabh; Budhiraja, Ravika Kanish; Bassi, Roopam

doi:10.18203/issn.2455-4529.intjresdermatol20172217

Cited by 4 publications

(3 citation statements)

References 7 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%

See 1 more Smart Citation

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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“…5 Although rare, few cases of azathioprine-induced anagen effluvium has been reported in past. 6,7 In 1884, Le Page coined the term "plica neuropathica" while describing a young female who suddenly developed a tangled scalp, and she had a history of hysteria. 2 Other terms for the same disorder include felting and bird's-nest hair.…”

Section: Discussionmentioning

confidence: 99%

A rare case of azathioprine induced anagen effluvium and plica neuropathica

Rijhwani,

Patel,

Malik

et al. 2024

Int J Res Dermatol

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Anagen effluvium is a type of hair loss that results from a sudden decrease in the metabolic activity of the hair follicle’s matrix cells. The condition is commonly associated with cancer treatments such as chemotherapy and radiation, but can also be caused by other factors. Plica neuropathica, on the other hand, is a condition where hair on the scalp becomes irreversibly matted. It is often linked to psychiatric disturbances, poor hair care, scalp infestations, and the use of ionic surfactants in shampoos. In rare cases, it has also been associated with certain medications. Here we present a rare case of a 16-year-old female who was on azathioprine and was diagnosed with an overlap of both conditions.

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Azathioprine-Induced Anagen Effluvium: A Case Series of Three Cases

Supekar,

Chopkar,

Gawali

et al. 2024

VJIM

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Azathioprine is a commonly used drug in dermatology for immunobullous diseases, vitiligo, and lichen planus alopecia areata. Azathioprine is rarely known to cause the acute onset of anagen effluvium (AE) that may precede myelosuppression associated with it. We report a series of three cases of azathioprine-induced AE. All three of our cases were females who were treated with azathioprine for non-dermatological conditions such as neuromyelitis optica, idiopathic thrombocytopenia, and optic neuritis. We report this series mainly due to its rarity.

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Azathioprine induced anagen effluvium: a rare case report

Cited by 4 publications

References 7 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

A rare case of azathioprine induced anagen effluvium and plica neuropathica

Azathioprine-Induced Anagen Effluvium: A Case Series of Three Cases

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