Persistent cutaneous lesion in a child with tyrosinemia: Esomeprazole‐induced lichenoid drug eruptions

Abstract

Lichenoid drug eruptions (LDEs) are among well‐recognized adverse reactions that different drugs including Proton‐pump inhibitors (PPIs) are associated with. LDEs are rare adverse reaction of PPIs but they should be considered as appropriate management can lead to full resolution. Herein, we report a case of Esomeprazole‐induced LDE in a child with tyrosinemia.

Esomeprazole-induced lichen planus

“…Adverse drug reactions frequently involve the skin and follow, in most cases, benign courses. LDEs are relatively uncommon 4 (unlike maculopapular rashes) and usually present in adults (median age 57-66 years) 5 .…”

“…Proton-pump inhibitors (PPI) are one of the most commonly prescribed drug classes, and there are several published reports of cutaneous reactions associated with its use. These range from immediate immunoglobulin E mediated reactions (urticaria and anaphylaxis) to delayed-type hypersensitivity "Stevens-Johnson/toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, fixed drug eruption, and drug-induced subacute lupus erythematosus, among others" 4,7 . There are three published case reports of PPI-induced LP 2,4,8 .…”

“…These range from immediate immunoglobulin E mediated reactions (urticaria and anaphylaxis) to delayed-type hypersensitivity "Stevens-Johnson/toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, fixed drug eruption, and drug-induced subacute lupus erythematosus, among others" 4,7 . There are three published case reports of PPI-induced LP 2,4,8 . Two patients were older males (median age 79.5 years) 2,8 , one of whom developed LDE to several PPIs 8 .…”

“…Two patients were older males (median age 79.5 years) 2,8 , one of whom developed LDE to several PPIs 8 . The remaining case was a 2-year-old girl treated with esomeprazole 4 . Resolution of symptoms with drug withdrawal was reported in two of these cases 4,8 .…”

“…The remaining case was a 2-year-old girl treated with esomeprazole 4 . Resolution of symptoms with drug withdrawal was reported in two of these cases 4,8 .…”