Photodistributed Lichenoid Drug Eruption with Rhabdomyolysis Occurring during Leflunomide Therapy

Gutierrez, Emilce Rivarola de; Abaca, H.

doi:10.1159/000077307

Cited by 23 publications

(16 citation statements)

References 8 publications

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“…Unlike methotrexate, which has greater hepatotoxicity in patients with PsA than in those with RA [9], leflunomide does not appear to have an increased effect on the liver in patients with PsA compared to those with RA. Although in our study leflunomide treatment resulted in favorable effects on psoriatic skin, there have been single case reports of drug eruptions and other skin reactions in patients receiving oral leflunomide [39, 40]. Similar cutaneous adverse events, usually related to allergic reactions, have also been reported with other DMARDs.…”

Section: Discussionsupporting

confidence: 59%

Leflunomide Improves Psoriasis in Patients with Psoriatic Arthritis: An In-Depth Analysis of Data from the TOPAS Study

et al. 2006

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Background: Leflunomide has shown promise in the treatment of psoriasis. Objective: To provide an in-depth analysis of the effect of leflunomide on psoriasis in patients with psoriatic arthritis (PsA). Methods: 190 patients with plaque psoriasis (at least 3% skin involvement) and active PsA were randomized to double-blind treatment with leflunomide (100 mg/day loading dose for 3 days followed by 20 mg/day orally) or placebo for 24 weeks. Results: As previously reported, leflunomide resulted in a significantly higher Psoriatic Arthritis Response Criteria response rate than placebo (58.9 vs. 29.7%; p < 0.0001). Significant differences in favor of leflunomide were also observed in the Psoriasis Area and Severity Index (PASI 50 in 30.4% of patients vs. 18.9% for placebo; p = 0.05), target lesion response (46.4 vs. 25.3%; p = 0.0048), combined skin and joint response (27.2 vs. 8.9%; p < 0.0001), Dermatology Life Quality Index (improvement of 1.9 points vs. 0.2; p = 0.0173) and certain SF-36 subdomains. Dermatological responses were observed at the earliest examination (4 weeks) and increased throughout the 24-week study. Conclusion: Once-daily oral leflunomide is an effective and convenient treatment for PsA and plaque psoriasis.

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Section: Discussionsupporting

confidence: 59%

Leflunomide Improves Psoriasis in Patients with Psoriatic Arthritis: An In-Depth Analysis of Data from the TOPAS Study

et al. 2006

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“…Cutaneous reactions caused by leflunomide have been reported in other countries (17)(18)(19)(20)(21)(22). But in China, to our knowedge, there has not severe cutanteous reactions reported caused by leflunomide.…”

Section: Introductionmentioning

confidence: 71%

Severe Cutaneous Adverse Drug Reaction to Leflunomide: A Report of Two Cases

Jian

Guo

Ruan

et al. 2008

Cutaneous and Ocular Toxicology

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The purpose of this study was to report severe cutaneous reactions in two patients related with leflunomide. A 13-year-old girl was treated with leflunomide for systemic lupus erythematosus. Three months later a progressive generalized blistering formation occurred and epidermolysis appeared on her skin. Methylprednisolone pulse therapy and intravenous immunoglobulin were used to control the severe cutaneous reactions. The patient recovered within 18 days. Another case is a 63-year-old woman who was treated with leflunomide for primary Sjögren's syndrome. Four months later widespread prunosus skin rash appeared on her skin. Methylprednisolone pulse therapy was also used to control the severe cutaneous reactions. The patient was recovered 11 days later. Our report suggests that an association between leflunomide intake and severe cutaneous reactions in rheumatic disease patients should be considered.

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“…35 Erythema multiforme 36 and toxic epidermal necrolysis [37][38][39] have also been reported. Other dermatologic diseases precipitated by leflunomide include a mucocutaneous lichen planuselike eruption, 40 a photodistributed lichenoid drug reaction, 41 Reiter syndrome, 42 leukocytoclastic vasculitis, 43,44 leg ulcers, 45 alopecia areata, 46 and a syringotropic hypersensitivity reaction. 47 Two patients with psoriatic arthritis also developed truncal ulcerations that improved after drug washout with cholestyramine.…”

Section: Side Effects and Adverse Cutaneous Eventsmentioning

confidence: 99%

Leflunomide in dermatology

Boyd

2012

Journal of the American Academy of Dermatology

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Photodistributed Lichenoid Drug Eruption with Rhabdomyolysis Occurring during Leflunomide Therapy

Cited by 23 publications

References 8 publications

Leflunomide Improves Psoriasis in Patients with Psoriatic Arthritis: An In-Depth Analysis of Data from the TOPAS Study

Leflunomide Improves Psoriasis in Patients with Psoriatic Arthritis: An In-Depth Analysis of Data from the TOPAS Study

Severe Cutaneous Adverse Drug Reaction to Leflunomide: A Report of Two Cases

Leflunomide in dermatology

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