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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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Spironolactone-Induced Lichenoid Drug Reaction and Subsequent Diffuse Eruptive Squamous Cell Carcinomas Successfully
Anuj Kunadia1, Kenneth Shulman2, Naveed Sami3
1Medicine, University of Central Florida College of Medicine, Orlando, USA.
Cureus
|October 15, 2021
Summary
Spironolactone can cause a lichenoid drug eruption that may lead to eruptive keratoacanthomas (KA) and squamous cell carcinoma (SCC). Systemic methotrexate proved effective in treating this patient, offering an alternative to intralesional treatments.
Area of Science:
- Dermatology
- Oncology
Background:
- Spironolactone, an antihypertensive, is associated with lichenoid drug eruptions.
- Lichenoid reactions can precede the development of eruptive keratoacanthomas (KA), a form of well-differentiated squamous cell carcinoma (SCC).
Observation:
- This case report details a patient experiencing a spironolactone-induced lichenoid drug eruption.
- The patient subsequently developed eruptive KA and SCC.
Findings:
- Treatment with systemic methotrexate was successfully employed.
- This approach was effective despite common use of intralesional methotrexate for similar conditions.
- Systemic methotrexate may also resolve the preceding lichenoid eruption.
Implications:
- This case highlights a rare adverse cutaneous effect of spironolactone.
- Systemic methotrexate offers a viable treatment option for widespread KA/SCC secondary to lichenoid drug eruptions.
- Further research is warranted on spironolactone's cutaneous effects and systemic methotrexate efficacy.
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