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Related Experiment Videos

Complicated lichenoid drug eruption.

Katherine Armour1, Patricia Lowe

  • 1Department of Dermatology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. katherine.armour@email.cs.nsw.gov.au

The Australasian Journal of Dermatology
|January 27, 2005
PubMed
Summary

This case study details a severe lichenoid drug eruption in a hepatitis C patient. Prompt treatment with oral prednisone and topical tacrolimus successfully resolved the drug-induced skin and mucosal lesions.

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Area of Science:

  • Dermatology
  • Pharmacology

Background:

  • Lichenoid drug eruptions are hypersensitivity reactions to medications.
  • Hepatitis C treatment regimens can involve multiple drugs with potential dermatological side effects.

Observation:

  • A hepatitis C-positive male presented with severe, polymorphic skin lesions including erosions, lichenification, and psoriasiform/eczematous changes.
  • Mucosal involvement included painful erosions on the vermilion, buccal mucosa, and glans penis.
  • The patient was on a complex medication regimen including pegylated interferon-alpha-2a, ribavirin, granulocyte colony-stimulating factor, and propranolol.

Findings:

  • Histological examination confirmed a lichenoid drug eruption.
  • The papulosquamous eruption responded rapidly to oral prednisone.

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  • Mucosal lesions showed a delayed response, necessitating the addition of topical tacrolimus.

    • Implications:

    • This case highlights the diverse clinical presentations of drug-induced eruptions.
    • It underscores the importance of considering drug reactions in patients with complex medical histories and polypharmacy.
    • Successful management involved a combination of systemic corticosteroids and topical immunomodulators.