Characterizing the adverse dermatologic effects of hydroxychloroquine: A systematic review

Area of Science:

• Dermatology
• Pharmacology
• Rheumatology

Background:

• Hydroxychloroquine is linked to various dermatologic side effects, but their frequencies and risk factors are not well-documented.
• Existing literature often lacks comprehensive characterization of these adverse events.

Purpose of the Study:

• To systematically review the dermatologic adverse effects associated with hydroxychloroquine.
• To identify predisposing factors contributing to hydroxychloroquine toxicity.

Main Methods:

• A systematic review of 94 articles was conducted.
• Included studies were case reports and clinical trials reporting at least one dermatologic adverse effect.

Main Results:

• 21 unique dermatologic reactions were identified, with drug eruption/rash being most common (358 cases).
• Other frequent reactions included hyperpigmentation (116 cases), pruritus (62 cases), and Stevens-Johnson syndrome/toxic epidermal necrolysis (26 cases).
• Most affected patients had lupus erythematosus (72%) or rheumatoid arthritis (14%), with reactions occurring at cumulative dosages ranging from 3g to 2500g.

Conclusions:

• Dermatologic adverse events from hydroxychloroquine may be under-reported in medical literature.
• Despite generally good tolerability, skin, hair, and nail complications are significant and frequent, particularly in autoimmune disease treatment.