Lansoprazole-induced Subacute Cutaneous Lupus Erythematosus: Two Cases

Bracke, Annick; Nijsten, Tamar; Vandermaesen, J.; Meuleman, L.; Lambert, Julien

doi:10.1080/00015550510026668

Cited by 21 publications

(19 citation statements)

References 13 publications

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“…In previously reported cases, the delay between the introduction of PPIs and the onset of SCLE symptoms varied between 3 days and 4 months and the clinical recovery occurred within 4-12 weeks [4,5,6,7]. In our 3 cases, this delay was 1 month (case 1), 7 weeks (case 2) and a few weeks (case 3).…”

Section: Discussionmentioning

confidence: 76%

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Subacute Cutaneous Lupus Erythematosus Induced and Exacerbated by Proton Pump Inhibitors

Almebayadh

Régnier‐Rosencher²,

Carlotti³

et al. 2013

Dermatology

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Background: Subacute cutaneous lupus erythematosus (SCLE) can be induced by numerous drugs. We report 3 cases of SCLE induced by proton pump inhibitors (PPIs). Objective: To highlight a rare cutaneous side effect induced by a frequently prescribed drug such as a PPI. Case Reports: Case 1 was a 30-year-old man who developed multiple annular plaques over the trunk and lower limbs 1 month after the initiation of pantoprazole. Antinuclear antibodies (ANA) were positive with anti-Ro/SSA and anti-La/SSB antibodies, and histology confirmed the diagnosis. Clinical improvement was achieved 8 weeks after the discontinuation of pantoprazole and the introduction of a treatment combining topical steroids and hydroxychloroquine. Lesions relapsed when pantoprazole was accidentally rechallenged. The second case was a 31-year-old woman, 28 weeks pregnant, who presented erythematous annular plaques over the trunk 7 weeks after starting esomeprazole. ANA and anti-Ro/SSA antibodies were positive, and the histology was compatible with SCLE. Fetal ultrasound was normal. She was treated with topical and oral steroids and hydroxychloroquine. Clinical improvement was achieved 4 weeks after the discontinuation of esomeprazole. The third case was a 57-year-old woman with systemic erythematosus lupus presenting annular and psoriasiform lesions on the trunk for 15 months. She was treated successively with hydroxychloroquine, azathioprine, mycophenolate mofetil and methotrexate with prednisone. A review of her drug history revealed the introduction of omeprazole a few weeks before the first appearance of skin lesions and omeprazole was contraindicated. Conclusion: SCLE should systematically be suspected in case of eruption after the introduction of PPI. The risk of fetal cardiac complications is important in pregnant women.

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Section: Discussionmentioning

confidence: 76%

“…Twelve cases have been reported: 5 with omeprazole [1,4,5,6], 5 with lansoprazole [1,7,8] and 2 with pantoprazole [1]. Moreover, in a Swedish population-based matched case-control study of 234 patients with SCLE, 65 received PPI.…”

Section: Discussionmentioning

confidence: 99%

Subacute Cutaneous Lupus Erythematosus Induced and Exacerbated by Proton Pump Inhibitors

Almebayadh

Régnier‐Rosencher²,

Carlotti³

et al. 2013

Dermatology

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“…This is further supported by the literature which, to date, only has four case reports that describe an association between PPI and TEN (Table 1). Other severe skin reactions also associated with PPI include subacute cutaneous lupus erythematosus, 12 lichenoid drug eruption, 13 allergic contact dermatitis 14 and angioedema. 15 However, none of these conditions have the high morbidity and mortality associated with TEN.…”

Section: Discussionmentioning

confidence: 98%

Toxic epidermal necrolysis and neutropaenia: Complications of omeprazole

Thakor¹,

Burke²,

Handfield‐Jones³

et al. 2009

Aust J Dermatology

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Worldwide, proton pump inhibitors (PPI) are one of the most frequently prescribed drugs; however, up to 70% of patients taking these drugs have no appropriate indication. Although PPI are relatively well tolerated, they are not free from side-effects and several life-threatening complications are associated with them. In the present report, a 43-year-old woman presented to her general practitioner with an erythematous rash over her face and chest, having been started on omeprazole for chronic abdominal bloating. Over the next 24 h she became increasingly unwell and was admitted to hospital with shortness of breath, pyrexia and the rash spreading over her back, arms and legs. Vesicles had now started to appear within the erythematous regions over her upper body and within 24 h the rash became confluent and desquamative, spreading to involve her entire body. A diagnosis of toxic epidermal necrolysis (TEN) was made. Despite supportive treatment within a critical care setting, she became neutropaenic and her skin loss became more extensive, resulting in 95% epidermal detachment. This case highlights that TEN is a life-threatening condition associated with a high incidence of morbidity and mortality. Optimal management requires early diagnosis and transfer to a specialized unit. Clinicians need to be aware that PPI are not free from side-effects and that their routine prescription should be strongly discouraged.

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“…Taking this phenomenon into account, we would like to support the proposal by Bracke et al . [2], who suggested the need to modify the criteria for drug-induced SCLE by changing “the presence of anti-histone antibodies” to “the presence of anti-Ro antibodies”.…”

mentioning

confidence: 99%