Pompholyx and eczematous reactions associated with intravenous immunoglobulin therapy

Gerstenblith, Meg R.; Antony, Ashley K.; Junkins‐Hopkins, Jacqueline M.; Abuav, Rachel

doi:10.1016/j.jaad.2010.12.034

Cited by 44 publications

(42 citation statements)

References 37 publications

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“…The authors noticed that most of the cases of IVIGrelated pompholyx reported in the literature occurred among patients who had received IVIG for neurologic affections (31/37 cases described in this review), although considering the bias of more frequent use of IVIG therapy by neurologists (2). Inaddition, it should be pointed out that IVIGs for neurological diseases are generally administrated at higher doses than those used for immunodeficiency disorders (6).…”

Section: Discussionmentioning

confidence: 82%

“…It is possible that CIS may have a role in predisposition of this reaction, as hypothesised by Gerstenblith et al (6) even iffurther studies, including studies of pharmacogenomics, are necessary for an adequate comprehension of the pathogenic mechanisms that underlie this complex adverse skin reaction.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Gerstenblith et al (6) reported that several types of IVIGs correlate with a different risk of occurrence of pompholyx. In particular, Sandoglobulin" has been associated with a major risk of pompholyx compared to Gammagard" and Tegeline".…”

Section: Discussionmentioning

confidence: 99%

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Pompholyx of the Hands after Intravenous Immunoglobulin Therapy for Clinically Isolated Syndrome: A Paediatric Case

Brazzelli

Grassi

Savasta

et al. 2014

Int J Immunopathol Pharmacol

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Pompholyx is a common eruption of small vesicles on the palms, soles, and/or lateral aspects of the fingers. It has a multifactorial etiology, including genetic determinants, allergy to metals, and id reaction; rarely it is a drug-related side effect. We report a paediatric case of pompholyx of the hands related to the intravenous immunoglobulin (IVIG) therapy for Clinically Isolated Syndrome (CIS). A to-year-old boy, received an IVIG therapy [Venital", Kedrion Spa, Italy) at a dose of 400 mg/kg daily for five days. The fifth day of IVIG infusion, a symmetrical vesicular eruption appeared on the palms of the hands and on lateral aspects of the fingers. The lesions improved with application of topical steroids in few days. The mechanism of induction of pompholyx by IVIG therapy is unknown. A review of the Literature suggests the hypothesis that dyshidrotic eczematous reactions may be related not only to the type of IVIG, to the dose and the rates of infusion, but also to an allergic response to excipients and preservatives contained in the drug, probably elicited by an underlying neurological disease in some cases.Pompholyx is a common, acute eruption of small (1-2 mm) vesicles on the palms, soles, and/or lateral aspects of the fingers, usually with a symmetrical distribution. It more often occurs in spring and fall, and generally has a self-limited course. Even if pathogenesis is not completely known, pompholyx has been regarded as a disease with a multifactorial etiology, including genetic determinants, allergy to metals, id reaction, and, rarely, it may be photoinduced or drug-induced (l, 2). Management of pompholyx needs to be adapted to etiology and includes local and systemic therapies, such as corticosteroids, calcineurin inhibitors, bexarotene gel, retinoids, and antihistamines (1).We report a paediatric case of pompholyx related to the IVIG therapy for Clinically Isolated Syndrome (CIS). CIS is the term to describe a neurological attack, lasting at least 24 h, characterized by optic neuritis, internuclear ophthalmoplegia, or partial myelitis, and it is associated with a major risk of developing multiple sclerosis (3). Case historyA lO-year-old boy with acute onset of dizziness, diplopia, right eyelid ptosis, and divergent strabismus of the right eye was hospitalized in the Department of Paediatrics, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy. His past medical history was unremarkable. Viral serologic analyses for the detection of cytomegalovirus, Epstein virus and hepatitis virus were negative. Magnetic resonance imaging revealed findings suggestive

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pompholyx of the Hands after Intravenous Immunoglobulin Therapy for Clinically Isolated Syndrome: A Paediatric Case

Brazzelli

Grassi

Savasta

et al. 2014

Int J Immunopathol Pharmacol

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show abstract

“…It has been associated with contact allergens, fungal infections, generalized eczema and intravenous immunoglobulin infusion. [1][2][3] When associated with intravenous immunoglobulin, symptoms typically occur within a few days of the infusion. On rechallenge with intravenous immunoglobulin, dyshidrosis can reoccur.…”

mentioning

confidence: 99%

“…On rechallenge with intravenous immunoglobulin, dyshidrosis can reoccur. [1][2][3] Dyshidrosis is typically treated with mid-to high-potency topical corticosteroids, along with frequent use of moisturizer. 1,2,4 Oral antihistamines may also be warranted for symptomatic relief of pruritus.…”

mentioning

confidence: 99%