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Sulfhydryl drug-induced eruption: a clinical and histological study
K Kitamura1, M Aihara, J Osawa
1Department of Dermatology, Yokohama City University, Japan.
The Journal of Dermatology
|January 1, 1990
Summary
Sulfhydryl drugs can cause diverse skin eruptions, clinically and histologically resembling graft-versus-host reactions. These reactions may stem from drug-induced immunologic changes.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Sulfhydryl drugs, including tiopronin, D-penicillamine, captopril, and gold sodium thiomalate, possess a thiol group or release sulfhydryl compounds.
- These drugs are known to cause various adverse skin reactions.
Purpose of the Study:
- To investigate the clinical and histological features of skin eruptions induced by sulfhydryl drugs.
- To compare these features with cutaneous graft-versus-host reactions (GVHR).
Main Methods:
- Clinical and histological examination of skin eruptions in 23 patients treated with sulfhydryl drugs.
- Skin testing with sulfhydryl compounds.
- Serological testing for autoantibodies.
Main Results:
- Clinical presentations varied, including maculopapular, erythema multiforme-like, eczematous, psoriasis-like, seborrheic dermatitis-like, Gibert-like, lichen planus-like, and pemphigus-like eruptions.
- Histological findings showed epidermal vacuolation and eosinophilic necrosis with lymphoid infiltrates, and dermal perivascular infiltrates, resembling cutaneous GVHR.
- 19 of 20 subjects had positive skin tests to sulfhydryl compounds, and 8 of 12 had detectable autoantibodies.
Conclusions:
- Sulfhydryl drug-induced skin eruptions exhibit a wide range of clinical and histological features.
- These reactions share similarities with cutaneous graft-versus-host reactions.
- Sulfhydryl drugs likely induce immunologic alterations, leading to these distinctive dermatological responses.