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[Lichenoid drug reaction to leflunomide]
D Canonne-Courivaud1, O Carpentier, Y Dejobert
1Clinique de Dermatologie, Hôpital Claude-Huriez, CHRU Lille.
Annales De Dermatologie Et De Venereologie
|July 5, 2003
Summary
Leflunomide, used for rheumatoid arthritis, can cause a rare lichenoid drug reaction. This case highlights the importance of considering leflunomide-induced skin reactions and their effective management.
Area of Science:
- Dermatology
- Rheumatology
- Immunology
Background:
- Leflunomide (Arava) is an immunomodulatory drug used for rheumatoid arthritis.
- Cutaneous side effects of leflunomide are generally infrequent and benign.
- This report details a rare case of lichenoid drug reaction associated with leflunomide therapy.
Observation:
- A 64-year-old woman developed pruritic lichenoid papules on her extremities and trunk two months after starting leflunomide.
- Skin biopsy confirmed a drug-induced lichenoid eruption.
- Lesions resolved with drug discontinuation, colestyramine washout, and topical corticosteroids.
Findings:
- The clinical presentation, histological findings, and rapid improvement upon leflunomide withdrawal strongly suggest drug-induced lichenoid eruption.
- Patch testing for leflunomide was negative.
- This case underscores the potential for leflunomide to cause significant cutaneous reactions.
Implications:
- Clinicians should consider leflunomide as a potential cause of lichenoid drug eruptions in patients with rheumatoid arthritis.
- Prompt recognition and management, including drug withdrawal, are crucial for resolution.
- Further investigation into leflunomide's dermatological adverse effects is warranted.