Ritodrine-induced Pustular Eruptions Distinctly Resembling Impetigo Herpetiformis

Kuwabara, Yoshimitsu; Sato, Atsuki; Abe, Hiroko; Abe, Sumino; Kawai, Naoki; Takeshita, Toshiyuki

doi:10.1272/jnms.78.329

Cited by 12 publications

(7 citation statements)

References 17 publications

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“…Since betablockers reportedly worsen psoriasis [97], our results may seem unexpected. However, failure to find an association of beta-blockers and psoriasis has also been reported [98] and it has been reported that beta-adrenergic agonists induce or worsen pustular psoriasis, concordant with our findings [99,100]. …”

Section: Discussionsupporting

confidence: 93%

Norepinephrine and adenosine-5′-triphosphate synergize in inducing IL-6 production by human dermal microvascular endothelial cells

et al. 2013

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Endothelial cells (ECs) play important roles in cutaneous inflammation, in part, by release of inflammatory chemokines/cytokines. Because dermal blood vessels are innervated by sympathetic nerves, the sympathetic neurotransmitter norepinephrine (NE) and the co-transmitter adenosine-5’-triphosphate (ATP) may regulate expression of EC inflammatory factors. We focused on IL-6 regulation because it has many inflammatory and immune functions, including participation in Th17 cell differentiation. Strikingly, NE and ATP synergistically induced release of IL-6 by a human dermal microvascular endothelial cell line (HMEC-1). Adrenergic antagonist and agonist studies indicated that the effect of NE on induced IL-6 release is primarily mediated by β2-adrenergic receptors (ARs). By real-time PCR IL-6 mRNA was also synergistically induced in HMEC-1 cells. This synergistic effect of NE and ATP was reproduced in primary human dermal endothelial cells (pHDMECs) and is also primarily mediated by β2-ARs. Under conditions of stress, activation of the symphathetic nervous system may lead to release of ATP and NE by sympathetic nerves surrounding dermal blood vessels with induction of IL-6 production by ECs. IL-6 may then participate in immune and inflammatory processes including generation of Th17 cells. Production of IL-6 in this manner might explain stress-induced exacerbation of psoriasis, and perhaps, other skin disorders involving Th17-type immunity.

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Section: Discussionsupporting

confidence: 93%

Norepinephrine and adenosine-5′-triphosphate synergize in inducing IL-6 production by human dermal microvascular endothelial cells

et al. 2013

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“…In a report of IH triggered by N-butyl-scopolammonium bromide, IH developed in 34th week of gestation after five days of drug ingestion [ 10 ]. Ritodrine hydrochloride, a drug that has been used to suppress preterm uterine contractures, has also been reported to induce IH [ 11 ].…”

Section: Pathogenesismentioning

confidence: 99%

Impetigo Herpetiformis: Review of Pathogenesis, Complication, and Treatment

Namazi

Dadkhahfar

2018

Dermatology Research and Practice

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Impetigo herpetiformis (IH) is among rare dermatosis of pregnancy, which is currently considered as a form of generalized pustular psoriasis. It is diagnosed by characteristic lesions of erythematous patches and grouped pustules mostly in the third trimester of pregnancy and may have systemic associations. A variety of complications have been reported in the course of IH. Treatment of IH can be quite challenging, and a number of treatment options have been reported to be effective for the management.

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“…In Guerriero’s case, after 5 days of N -butyl-scopolammonium bromide therapy, a woman developed PPP at 34 weeks’ gestation [ 13 ]. PPPs caused by ritodrine hydrochloride in a nulligravida woman at 31 weeks’ gestation has also been reported [ 14 ]. Our patient did not have family or personal history of psoriasis, nor did her second pregnancy have psoriasis relapse.…”

Section: Discussionmentioning

confidence: 99%

First-Trimester Impetigo Herpetiformis Leads to Stillbirth: A Case Report

Liu

Ali

Lou

et al. 2022

Dermatol Ther (Heidelb)

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Introduction Pustular psoriasis of pregnancy (PPP), also known as impetigo herpetiformis (IH), is a rare variant of generalized pustular psoriasis (GPP) in pregnancy. It typically occurs in the third trimester and is a life-threatening condition for both the pregnant mother and the fetus if not diagnosed and treated promptly. Drug-induced PPP has been reported in sporadic case reports. Here we present a case of first-trimester PPP occurring after applying drugs including chloroquine, which we consider a possible culprit triggering the disease. Case report A 29-year-old female was admitted to our department at 45 days gestation with sudden onset of fever and widespread erythematous pustules for 9 days. She had been on medications including hydroxychloroquine before onset. The eruptions and systemic symptoms were controlled with high-dose systemic steroids; however, she was detected to have a stillbirth, and underwent dilation and curettage of the uterine. At the latest follow-up about 2 years after her admission, she reported to have delivered a healthy baby about 1 month previously. Conclusions Chloroquine has potential to lead to PPP in the first trimester of pregnancy. Further studies are warranted to investigate the etiology and treatment of PPP to facilitate early recognition and optimal management of this relatively rare dermatosis in pregnancy.

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Ritodrine-induced Pustular Eruptions Distinctly Resembling Impetigo Herpetiformis

Cited by 12 publications

References 17 publications

Norepinephrine and adenosine-5′-triphosphate synergize in inducing IL-6 production by human dermal microvascular endothelial cells

Norepinephrine and adenosine-5′-triphosphate synergize in inducing IL-6 production by human dermal microvascular endothelial cells

Impetigo Herpetiformis: Review of Pathogenesis, Complication, and Treatment

First-Trimester Impetigo Herpetiformis Leads to Stillbirth: A Case Report

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