Pityriasis rosea‐like eruption associated with ondansetron use in pregnancy

Abstract

A 30-year-old pregnant female presented with a 2-week history of pityriasis rosea-like eruption. The rash started 2 days after the patient had started taking ondansetron 8 mg for alleviation of moderate-to-severe nausea and vomiting of pregnancy. Physical examination revealed erythematous papulosquamous lesions characterized by annular scaly margins and a dusky centre over the arms, chest, abdomen, lower back and legs. The rash did not involve the palms, sole or mucous membranes, and no lesions were observed on the lymph nodes. Ondansetron was discontinued. The rash ceased to spread and started to disappear within 2 weeks with full resolution noted after 1 month. Analysis of the case using the Naranjo adverse drug reaction probability scale indicated that ondansetron was the probable cause of the pityriasis rosea-like eruption. This is the first case report of pityriasis rosea related to ondansetron therapy.

Pityriasis rosea in pregnancy: A case series and literature review

“…It typically begins with a single plaque, followed by exanthematous spread after a latency period of 10-14 days. The rash may last from two weeks to a few months and may be accompanied by additional symptoms such as fever, headache, malaise, or lymph node swelling [3][4][5][6][7]. The differential diagnosis of PR includes nummular eczema, pityriasis lichenoides chronica, guttata psoriasis, drug eruption, syphilis, and, in the case of pregnancy, polymorphic and atopic eruptions of pregnancy [3,4].…”

Reply: Commentary on letter to the editor from Drago et al

“… 2 Unfortunately, we did not evaluate our patient for the presence of HHV-6/7 serum antibodies or plasma DNA during the acute phase of the eruption. 3 , 4 , 5 , 6 Regarding peripheral eosinophilia, our patient had transient eosinophilia with absolute eosinophil count of 880. The presence of eosinophilia might support a drug-induced eruption; however, most of the PR-like eruptions present with normal eosinophil count.…”

Unusual Localised Skin Reaction due to Ondansetron: Case Series

“…Ondansetron belongs to antiemetic group of drugs which act by antagonising the 5 hydroxytryptamine 3 (5-HT 3 ) receptors 2 . The other drugs included in this group are granisetron, palonosetron, dolasetron and tropisetron.…”

“…Due to this, some researchers recommend that the medication's utilization ought to be limited 10 . Extreme nausea/vomiting not responding to other antiemetics and Nausea/Vomiting of Pregnancy (NVP) are additionally regular unlabelled indications for the utilization of Ondansetron 2,11 .…”