Eczematous Reaction to Intravenous Immunoglobulin

Miyamoto, Junpei; Böckle, Barbara C.; Zillikens, Detlef; Schmidt, Enno; Schmuth, Matthias

doi:10.1001/jamadermatol.2014.109

Cited by 13 publications

(5 citation statements)

References 9 publications

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“…The pathogenesis of the eczematous skin reaction to IVIG is unknown. 24 Various B cell responses and epidermal complement deposits that occur after IVIG treatment have been partially explained. 24 Furthermore, IVIG is associated with T-cell modulation.…”

Section: Discussionmentioning

confidence: 99%

“…24 Various B cell responses and epidermal complement deposits that occur after IVIG treatment have been partially explained. 24 Furthermore, IVIG is associated with T-cell modulation. Another hypothesis is that the delayed hypersensitivity skin reaction is due to the activation of drug specific CD4+ and CD8+ T cells, which triggers these eczematous reactions.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Eczematous skin reaction after intravenous immunoglobulin therapy in axonal Guillain-Barré syndrome

Oh¹,

Seol²,

Hong³

et al. 2022

NeuroAsia

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Background: Intravenous immunoglobulin (IVIG) treatment in Guillain-Barré syndrome (GBS) is relatively easy to administer and safe due to infrequent, non-severe side effects. Adverse effects can include skin reactions, the causes of which have not been fully elucidated. In this study, we investigated skin reactions following IVIG treatment for acute inflammatory neuropathy. We examined the relationship between the clinical results in the neuropathy and the clinical profile of skin reactions. Methods: We retrospectively analyzed patients with skin reactions that developed after IVIG treatment in acute immune-mediated or inflammatory neuropathy [GBS or Miller Fisher syndrome (MFS)] based on the dermatologic evaluation. Results: Ninety-six patients with acute inflammatory neuropathy were treated with IVIG during the study period. Thirteen cases (13.5%), with age at onset ranging from 22–69 years (mean, 50.3 years), developed skin reactions after IVIG treatment. The features accompanying skin reactions were hand eczema, including pompholyx (9/13, 82%), generalized eczematous eruption (2/13, 15.4%), and contact dermatitis, including folliculitis. The electrophysiological classification of 11 patients with classical GBS showed that nine patients (81.8 %) had axonal neuropathy, and one (9.1 %) had acute inflammatory demyelinating polyradiculoneuropathy. Conclusions: Eczematous skin reactions or pompholyx are the most common skin reactions following IVIG treatment in axonal GBS. These reactions were relatively minor and recovered well. Although adverse skin reactions to IVIG were usually benign and the precise mechanism of this cutaneous eruption remains unknown, its occurrence within days of IVIG treatment can be managed effectively if recognized by neurologists.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Eczematous skin reaction after intravenous immunoglobulin therapy in axonal Guillain-Barré syndrome

Oh¹,

Seol²,

Hong³

et al. 2022

NeuroAsia

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“…Miyamoto et al described a case of diffuse eczema affecting the face, trunk, extremities, and palmoplantar region following IVIg therapy for peripheral neuropathy. The patient's skin rash regressed with systemic steroid treatment, and no IVIg therapy was readministered 11 . Vecchietti et al documented four cases of intense eczematous cutaneous eruption approximately 10 days after high‐dose IVIg infusion (0.4 g/kg for five consecutive days) for polyradiculoneuritis, characterized by an eczematous rash on the palms and soles initially and then becomes generalized to the whole body.…”

Section: Discussionmentioning

confidence: 99%

Dyshidrotic eczema and seborrheic dermatitis‐like eczematous eruption following intravenous immunoglobulin therapy

Takçı

Şimşek

Uzuner

et al. 2020

Dermatologic Therapy

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Intravenous immunoglobulin (IVIg) is increasingly used for the treatment of inflammatory and autoimmune diseases. Although skin reactions to IVIg therapy are usually minor, rare, and not life-threatening, dermatologists need to recognize the nature of these adverse reactions. We describe a 33-year-old man suffering from demyelinating polyneuropathy who developed dyshidrotic eczema on the palms and flaky grayishwhite scales on an erythematous base on his face after the administration of IVIg.

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“…99,100 Cutaneous adverse reactions in the form of urticarial plaques during the infusion are common, whereas delayed skin reactions in the form of eczema, erythema multiforme, purpuric erythema, or maculopapular rash are infrequent. [101][102][103] Slowing the infusion rate of immunoglobulin could help reduce infusion reactions. 101 In the presence of compatible infusion-related skin lesions, the infusion should be temporarily discontinued, and treatment with oral/intravenous diphenhydramine or corticosteroids may be administered.…”

Section: Immunoglobulin Therapymentioning

confidence: 99%

“…[101][102][103] Slowing the infusion rate of immunoglobulin could help reduce infusion reactions. 101 In the presence of compatible infusion-related skin lesions, the infusion should be temporarily discontinued, and treatment with oral/intravenous diphenhydramine or corticosteroids may be administered. 104 Moreover, patients may infrequently develop systemic sensitivity to immunoglobulin therapy, including anaphylaxis/anaphylactic reactions.…”

Section: Immunoglobulin Therapymentioning

confidence: 99%

Review of adverse cutaneous reactions of pharmacologic interventions for COVID-19: A guide for the dermatologist

Martínez-López

Cuenca‐Barrales

Montero‐Vílchez

et al. 2020

Journal of the American Academy of Dermatology

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The new coronavirus SARS-CoV-2 is associated with a wide variety of cutaneous manifestations. While new skin manifestations caused by COVID-19 are continuously being described, other cutaneous entities should also be considered in the differential diagnosis, including adverse cutaneous reactions to drugs used in the treatment of COVID-19 infections. The aim of this review is to provide dermatologists with an overview of the cutaneous side effects associated with the most frequently prescribed drugs in patients with COVID-19. The skin reactions of antimalarials (chloroquine and hydroxychloroquine), antivirals (lopinavir/ritonavir, ribavirin +/- interferon, oseltamivir, remdesivir, favipiravir and darunavir) and treatments for complications (imatinib, tocilizumab, anakinra, immunoglobulins, corticosteroids, colchicine and low molecular weight heparins) are analyzed. Information regarding possible skin reactions, their frequency, management and key points for differential diagnosis are presented.

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Eczematous Reaction to Intravenous Immunoglobulin

Cited by 13 publications

References 9 publications

Eczematous skin reaction after intravenous immunoglobulin therapy in axonal Guillain-Barré syndrome

Eczematous skin reaction after intravenous immunoglobulin therapy in axonal Guillain-Barré syndrome

Dyshidrotic eczema and seborrheic dermatitis‐like eczematous eruption following intravenous immunoglobulin therapy

Review of adverse cutaneous reactions of pharmacologic interventions for COVID-19: A guide for the dermatologist

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