Ticagrelor-induced Sweet Syndrome: an unusual dermatologic complication after percutaneous coronary intervention

Area of Science:

• Cardiology
• Dermatology
• Pharmacology

Background:

• Drug-eluting stents (DES) are commonly used to treat coronary artery stenosis.
• Ticagrelor is a P2Y12 inhibitor prescribed as dual antiplatelet therapy post-stenting.

Observation:

• A 73-year-old male presented with painful hemorrhagic bullae on his hands after cardiac catheterization with Everolimus-eluting stents and ticagrelor treatment.
• Skin biopsy confirmed lesions consistent with Sweet Syndrome (SS).

Findings:

• The patient's symptoms resolved after discontinuing ticagrelor and initiating corticosteroid therapy.
• This case represents the first documented instance of Sweet Syndrome associated with ticagrelor use.

Implications:

• This finding suggests a potential adverse drug reaction between ticagrelor and the development of Sweet Syndrome.
• Clinicians should consider SS in patients presenting with similar dermatological symptoms while on ticagrelor.
• Further research is warranted to elucidate the mechanism and incidence of this association.