Clarithromycin induced psoriasis in a 37-year old man

Area of Science:

• Dermatology
• Pharmacology
• Clinical Medicine

Background:

• Drug-induced psoriasis is a recognized phenomenon, with various medications capable of inducing or worsening psoriatic lesions.
• Psoriasis vulgaris is a common chronic inflammatory skin condition characterized by erythematous, scaly plaques.

Observation:

• A 37-year-old male patient developed an erythemato-squamous eruption on his trunk and limbs.
• The eruption appeared on the third day of treatment with clarithromycin (500mg twice daily) for pharyngitis.
• The lesions were non-pruritic and histopathologically confirmed as typical psoriasis vulgaris.

Findings:

• Clarithromycin, a macrolide antibiotic, is suspected as the causative agent for the new-onset psoriasis vulgaris.
• Discontinuation of clarithromycin resulted in a rapid and significant improvement of the patient's skin condition.
• Topical corticosteroids were used as an adjunct treatment, contributing to the resolution of the lesions.

Implications:

• This case underscores the importance of considering drug-induced psoriasis in differential diagnoses, even with common antibiotics like clarithromycin.
• Physicians should be vigilant for potential dermatological side effects of clarithromycin and other antibiotics.
• Further investigation into the mechanisms of drug-induced psoriasis may inform safer prescribing practices and patient management strategies.