Hydroxychloroquine-Induced Retinopathy

Tripp, Jackie M.; Maibach, Howard I.

doi:10.2165/00128071-200607030-00003

Cited by 10 publications

(3 citation statements)

References 19 publications

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“…In this case, HCQ was selected because of its proven efficacy in human DLE, its relative safety at low dosages and its low cost 2,12,13 . The main adverse event limiting the use of HCQ in humans is the development of retinopathy 16,17 . This adverse effect is rare and is mainly seen in high‐risk patients, i.e.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of a novel generalized variant of canine discoid lupus erythematosus with oral hydroxychloroquine

Oberkirchner

Linder

Olivry

2011

Veterinary Dermatology

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Discoid lupus erythematosus (DLE) is a common canine autoimmune disease that usually manifests as a localized ulcerative and scarring nasal dermatitis. We report herein a generalized variant of canine DLE successfully treated with the antimalarial immunomodulator hydroxychloroquine (HCQ). A 9-year-old hairless Chinese crested dog was presented with annular and polycyclic hyperpigmented and scaly skin lesions with central erosions, hypopigmentation and/or scarring on the trunk, neck and lateral extremities. Associated systemic signs were not seen. The clinical diagnosis of generalized DLE was supported by the demonstration of lymphocyte-rich interface dermatitis with epidermal atrophy and dermo-epidermal deposition of immunoglobulins and activated complement. As for human DLE, treatment was initiated with HCQ at 5 mg/kg once daily along with 2 weeks of 0.1% tacrolimus ointment and restriction of sun exposure. Over the following year, complete remission was maintained with HCQ at 5 mg/kg orally once daily with the exception of three relapses; two occurred during treatment induction and the third arose when the frequency of HCQ administration was reduced to every other day. Disease flares were controlled with 0.1% tacrolimus ointment alternating with 0.1% prednicarbate cream once daily for 5-10 days. Altogether, adverse drug events were not seen with this regimen. In summary, clinically, histologically and immunologically, this dog's disease mirrored the generalized discoid variant of chronic cutaneous lupus erythematosus of humans. The apparent benefit of HCQ, its safety and low cost warrant future investigations of its use for treatment of canine cutaneous lupus variants.

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Section: Discussionmentioning

confidence: 99%

Successful treatment of a novel generalized variant of canine discoid lupus erythematosus with oral hydroxychloroquine

Oberkirchner

Linder

Olivry

2011

Veterinary Dermatology

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“…Hydroxychloroquine is first-line antimalarial therapy, due to a lower incidence of retinal toxicity compared to chloroquine [27]. In the CLE population, response to hydroxychloroquine ranges from 50% to 70% [28,29].…”

Section: Systemic Therapiesmentioning

confidence: 99%

Treatment of Cutaneous Lupus

Chang

Werth

2011

Curr Rheumatol Rep

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Cutaneous lupus erythematosus (CLE) is an autoimmune, inflammatory skin disease seen in patients with or without systemic lupus erythematosus (SLE). The management of CLE includes treatment and prevention of lesions, as well as routine assessment for systemic disease. Treatment options include both topical and systemic therapies. Topical therapies include corticosteroids and calcineurin inhibitors. Systemic therapies generally fall under one of three categories: antimalarials, immunomodulators, such as dapsone and thalidomide, and immunosuppressives, such as methotrexate and mycophenolate. Evidence for the treatment of CLE is limited by few prospective studies, as well as lack of a validated outcome measure up until recently. There is good evidence to support the use of topical steroids and calcineurin inhibitors, though most of these trials have not used placebo or vehicle controls. There have been no randomized placebo-controlled trials evaluating systemic therapies for the treatment of CLE.

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“… 6 More commonly, Caucasian patients with pericentral toxicity will also have paracentral changes that are readily detected with conventional screening techniques. 6 , 7 …”

Section: Discussionmentioning

confidence: 99%

Pericentral hydroxychloroquine retinopathy in a Caucasian female

Anand

Prinzi

Hoeferlin

et al. 2018

American Journal of Ophthalmology Case Reports

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PurposeTo report a rare presentation of the pericentral pattern of hydroxychloroquine (HCQ) retinal toxicity in a Caucasian female.ObservationsThe patient presented with 20 years of exposure to HCQ, at a daily dose of 5.2mg/kg of actual body weight, and manifested a pericentral-only phenotype of HCQ toxicity, as demonstrated with detailed structural and functional testing.Conclusions and importanceAlthough rare, the pericentral pattern of HCQ toxicity may occur in Caucasian patients in the absence of paracentral changes.

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Hydroxychloroquine-Induced Retinopathy

Cited by 10 publications

References 19 publications

Successful treatment of a novel generalized variant of canine discoid lupus erythematosus with oral hydroxychloroquine

Successful treatment of a novel generalized variant of canine discoid lupus erythematosus with oral hydroxychloroquine

Treatment of Cutaneous Lupus

Pericentral hydroxychloroquine retinopathy in a Caucasian female

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