Proton pump inhibitor-induced exfoliative dermatitis: A case report

Area of Science:

• Dermatology
• Gastroenterology
• Pharmacology

Background:

• Proton pump inhibitors (PPIs) are widely used for acid-related gastrointestinal disorders.
• Elderly patients and those with comorbidities may be at increased risk for adverse drug reactions.

Purpose of the Study:

• To report a case of potential PPI-induced exfoliative dermatitis in an elderly trauma patient.
• To investigate the association between PPI use, organ dysfunction, and severe cutaneous adverse events.

Main Methods:

• A case report of a 74-year-old female patient following a road accident.
• Analysis of clinical presentation, treatment with PPIs (lansoprazole, esomeprazole, omeprazole), and subsequent adverse events.
• Evaluation of patient's recovery after PPI discontinuation.

Main Results:

• The patient developed gastrointestinal bleeding and was treated with PPIs.
• Adverse skin reactions, including ulcerated rashes and tracheal mucosal injury with hemoptysis, emerged 28 days after PPI initiation.
• Symptoms significantly improved upon PPI cessation, with no new rashes appearing.

Conclusions:

• Long-term PPI use in elderly patients with hepatic ischemia, hypoxia, and acute renal failure may induce exfoliative dermatitis.
• Impaired drug metabolism due to organ dysfunction could lead to PPI metabolite accumulation and toxicity.
• This case highlights the importance of monitoring for severe cutaneous reactions during PPI therapy in vulnerable patient populations.