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[Severe pustular and polymorphous vasculitis caused by losartan].

C Piérard Franchimont1, F Henry, G E Piérard

  • 1Service de Dermatopathologie, CHU du Sart Tilman, Liège, Belgique.

Annales De Dermatologie Et De Venereologie
|March 23, 2002
PubMed
Summary

Severe pustular vasculitis, a rare skin reaction, was likely caused by the antihypertensive drug losartan. Prompt withdrawal of losartan and corticosteroid treatment led to lesion resolution.

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Area of Science:

  • Dermatology
  • Pharmacology
  • Immunology

Background:

  • Losartan is an angiotensin II receptor blocker used to treat hypertension.
  • Cutaneous side effects of losartan are rarely reported.
  • This case highlights a severe dermatological reaction potentially linked to losartan.

Observation:

  • A 64-year-old woman presented with a rapidly progressing bullous and pustular eruption.
  • The patient was taking losartan for hypertension and no other medications.
  • Skin biopsy revealed leucocytoclastic vasculitis and junctional blisters with IgA and IgG deposits.

Findings:

  • Discontinuation of losartan and a course of corticotherapy resulted in complete resolution of the skin lesions.
  • The patient developed mottled hyperpigmentation post-eruption.

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  • Antineutrophil cytoplasmic antibodies were present but did not correlate with recurrence.
  • Implications:

    • This case suggests losartan as a potential cause of severe, polymorphous cutaneous vasculitis.
    • Physicians should consider drug-induced vasculitis in patients presenting with similar dermatological manifestations.
    • Further investigation into the immunopathogenesis of losartan-induced skin reactions is warranted.