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"Black box warning" rash with entecavir - case report.
Xiong Khee Cheong1, Zhiqin Wong2, Norazirah Md Nor3
1Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Kuala Lumpur, Malaysia.
BMC Gastroenterology
|September 19, 2020
Summary
Entecavir, used for chronic hepatitis B, can cause a rare lichenoid drug eruption. This first reported case highlights the need for clinical awareness of this potential side effect.
Area of Science:
- Dermatology
- Hepatology
- Pharmacology
Background:
- Chronic hepatitis B is a global health concern, increasing risk for liver cirrhosis and cancer.
- Entecavir is an effective oral antiviral with a high genetic barrier for treating chronic hepatitis B.
- Cutaneous adverse reactions to entecavir are uncommon, with lichenoid drug eruption being rarely documented.
Observation:
- A 55-year-old male presented with a generalized, itchy, erythematous rash on his trunk and extremities.
- The patient had started entecavir for chronic hepatitis B six weeks prior.
- Skin biopsy showed acanthosis and focal lymphocytic infiltration.
Findings:
- The patient's skin condition resolved completely after discontinuing entecavir and a short course of oral corticosteroids.
- This case represents the first reported instance of entecavir-induced lichenoid drug eruption.
- Histopathology confirmed features consistent with a drug-induced reaction.
Implications:
- Clinicians should be aware of the potential for entecavir to cause lichenoid drug eruptions.
- Early recognition and management of cutaneous adverse reactions are crucial for patient care.
- This finding expands the known spectrum of side effects associated with entecavir therapy.
