Lichenoid drug reaction due to anti‐tubercular therapy presenting as erythroderma

Katare, Anusha; Arora, Pooja; Sardana, Kabir; Malhotra, Purnima

doi:10.1111/dth.13169

Cited by 5 publications

(4 citation statements)

References 11 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%

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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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“…LDE presenting as erythroderma due to ATDs has been reported by Katare et al . [ 19 ] However, none of our patients on anti-tubercular treatment presented with erythroderma.…”

Section: Discussionmentioning

confidence: 93%

Clinical Profile of Patients with Lichenoid Drug Eruption: A Observational Study

Bhanja,

Sil,

Maiti

et al. 2024

Indian Journal of Dermatology

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Background: Lichenoid drug eruption (LDE) is an uncommon cutaneous adverse drug reaction, where a variety of drugs used in day-to-day clinical practice have been implicated. Objective: To describe the clinico-demographic characteristics of patients with LDE and to identify the most likely drugs involved. Methods: In this prospective, observational study, consecutive patients with LDE presenting to the dermatology department of a tertiary teaching hospital were included. The clinico-demographic profile of patients with LDE and implicated drugs was noted. Treatment of drug reaction along with outcome was also documented. Naranjo adverse drug reaction probability scale was used for causality assessment of the drug reactions. A thorough literature review on LDE was also undertaken due to the paucity of existing literature. Results: A total of 15 patients (11 males and 4 females) with LDE were evaluated. Their age ranged from 37 to 61 years, with a mean of 51.53 ± 7.59 years. Anti-hypertensive medications (40%) were the most common culprit agent, followed by antitubercular drugs (33.4%), anti-diabetic agents (13.3%), and others (13.3%). The latent period (time from drug initiation to the appearance of a cutaneous eruption) varied from 15 days to 6 months (mean 2.2 months). Cutaneous involvement was generalized in 73.4% and photo-distributed lesions in 26.6%. Drug provocation test was done to identify the culprit drug. According to the Naranjo adverse drug reaction probability scale, one-third of LDEs were “definite,” whereas two-thirds were designated as “probable.” Conclusion: LDE is more common in the elderly population. The latent period is comparatively longer in LDE than in other common drug reactions. Prompt recognition and withdrawal of suspected drug are essential to minimize disease morbidity.

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“…[ 1 ] lichenoid drug eruption (LDE) usually has a latent period, ranging from a few weeks to several months, and resolves spontaneously following discontinuation of the offending drugs. [ 2 3 ] We report a case of LDE induced by anti-tubercular drugs.…”

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confidence: 99%

Generalized Lichen Planus-Like Eruption Related to Anti-Tubercular Drugs

Zhang

Tian

et al. 2023

Indian Journal of Dermatology

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Lichenoid drug reaction due to anti‐tubercular therapy presenting as erythroderma

Cited by 5 publications

References 11 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

Clinical Profile of Patients with Lichenoid Drug Eruption: A Observational Study

Generalized Lichen Planus-Like Eruption Related to Anti-Tubercular Drugs

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