Bullous Fixed Drug Eruption Secondary to Chlorthalidone

Cuervo-Pardo, N.; González-Estrada, Aurora; Cuervo‐Pardo, Lyda; Reddy, Keerthi; Gonzalez‐Estrada, Alexei

doi:10.1016/j.jaip.2017.06.037

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…FDE is a delayed cutaneous allergic reaction to a specific drug. Usually there is only one causative drug [4]. Allergic reaction to drugs are mainly classified as immediate reaction (IR) and non immediate reaction (NIR) depending upon duration of appearance of reaction.…”

Section: Resultsmentioning

confidence: 99%

“…One of the study found that reactions to cardiovascular drugs accounted for 9.30% of medication-related office visits to physicians in the United States with skin reactions being the most common primary complaint [3]. The drugs most commonly associated with FDE are antibiotics, analgesics, thiazide diuretics and anticonvulsants [4]. Chlorthalidone, a thiazidetype diuretic that inhibits distal convoluted tubule sodium and chloride resorption, is a commonly used oral antihypertensive [5,6].…”

Section: Introductionmentioning

confidence: 99%

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A Case Report on Thiazide-type Diuretic Induced Fixed Drug Eruption

Rawat¹,

Joshi²,

Sharma³

2018

AJPHR

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Fixed drug eruption (FDE) is one of the most common cutaneous adverse drug reactions in Indian patients. Chlorthalidone (CTD), a thiazide-type diuretic that inhibits distal convoluted tubule sodium and chloride resorption, is a commonly used oral antihypertensive. We are presenting a case of chlorthalidone induced FDE where a 75 year old hypertensive male admitted in hospital with complains of rashes associated with burning sensation on trunk, back and left arm after the administration of tablet chlorthalidone. FDE is believed to be a lymphocyte CD8-mediated reaction, wherein the offending drug may induce local reactivation of memory T cell lymphocytes localized in epidermal and dermal tissues and targeted initially by the viral infection. The initial treatment of FDE is discontinuation of the causative agent.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case Report on Thiazide-type Diuretic Induced Fixed Drug Eruption

Rawat¹,

Joshi²,

Sharma³

2018

AJPHR

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“…Since FDE diagnosis relies primarily on clinical evaluation, gathering a comprehensive medication history to pinpoint the responsible drug is crucial, as the treatment depends on abstaining from it [ 11 , 12 , 13 ] . In cases where diagnosis remains uncertain, patch testing, oral drug challenge, and skin biopsy can serve as valuable diagnostic tools [ 14 ]. Not addressing the removal of the causative agent in cases of localized FDEs can result in its return, leading to heightened inflammation, increased pigmentation, and an elevated risk of a potentially life-threatening generalized bullous FDE (GBFDE).…”

Section: Discussionmentioning

confidence: 99%

“…The decision of lifelong avoidance of thiazide diuretics is significant, as it acknowledges the potential for cross-reactivity between different drugs within the same class, which is a concern for patients with FDEs. Our literature review identified only one prior case in the United States, described as the first documented case [ 14 ]. The symptoms typically remit within a few days to weeks upon discontinuation of the implicated medication, although there is a possibility of developing persistent chronic hyperpigmentation [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…While extensive research and systematic reviews have shed light on various drug-induced skin reactions, chlorthalidone, a widely used diuretic, had not been prominently linked to FDEs in prior studies [10,17,18,19]. There are only a few cases in the literature of FDEs secondary to diuretics, such as furosemide or indapamide, and only two cases to chlorthalidone [14,20,21,22].…”

Section: Discussionmentioning

confidence: 99%

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Chlorthalidone-Induced Fixed-Drug Eruption: Unmasking an Uncommon Reaction to a Common Diuretic

Marrero Castillo,

Kaufman,

Valdes Camacho

et al. 2023

Cureus

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Fixed-drug eruptions (FDEs) are dermatological reactions characterized by specific skin lesions triggered by certain medications. Our case reports commonly used medications that can cause drug-induced skin reactions. Chlorthalidone, a widely used diuretic, had not been prominently linked to FDEs. Here, we present the case of a 45-year-old African-American male who developed classic FDE skin lesions following the initiation of chlorthalidone therapy. This case underscores the imperative for further investigation and heightened awareness among healthcare professionals regarding chlorthalidone-associated FDEs. Findings suggest that such reactions might be more prevalent than previously acknowledged, underscoring the significance of prompt diagnosis and effective management of drug-induced skin responses. Notably, the patient's lesions showed complete resolution upon discontinuing the diuretic, reinforcing the causal relationship. This case is an essential reminder of the importance of vigilance in monitoring patients for adverse drug reactions, even in unlikely medications, such as chlorthalidone.

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Chlortalidone

2018

Reactions Weekly

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Bullous Fixed Drug Eruption Secondary to Chlorthalidone

Cited by 4 publications

References 10 publications

A Case Report on Thiazide-type Diuretic Induced Fixed Drug Eruption

A Case Report on Thiazide-type Diuretic Induced Fixed Drug Eruption

Chlorthalidone-Induced Fixed-Drug Eruption: Unmasking an Uncommon Reaction to a Common Diuretic

Chlortalidone

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