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Giant cell lichenoid dermatitis.

J G Gonzalez, M D Marcus, D J Cruz

    Journal of the American Academy of Dermatology
    |July 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    A case report details drug-induced lichenoid dermatitis in a lupus patient. The unusual inflammatory response resolved after discontinuing antihypertensive medications, highlighting potential drug triggers for skin conditions.

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    Area of Science:

    • Dermatology
    • Immunology
    • Pathology

    Background:

    • Systemic lupus erythematosus (SLE) management can involve various medications.
    • Drug-induced hypersensitivity reactions can manifest with diverse dermatological symptoms.
    • Lichenoid dermatitis is an inflammatory skin condition characterized by specific microscopic features.

    Observation:

    • A 52-year-old woman with steroid-dependent systemic lupus erythematosus developed a generalized papulosquamous pruritic eruption.
    • The patient was concurrently taking methyldopa and chlorothiazide for hypertension.
    • The eruption significantly improved upon cessation of these antihypertensive agents and initiation of topical corticosteroids.

    Findings:

    • Microscopic examination revealed a lichenoid inflammatory pattern in the skin lesions.

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  • Key findings included epidermotropic multinucleated giant cells, cytoid bodies, and a mixed chronic inflammatory infiltrate (lymphocytes, histiocytes, eosinophils).
  • This specific inflammatory response was considered unusual for drug-induced lichenoid dermatitis.

    • Implications:

    • This case suggests that methyldopa and chlorothiazide can potentially induce lichenoid dermatitis.
    • The presence of epidermotropic multinucleated giant cells represents an atypical inflammatory response in this context.
    • Dermatologists should consider antihypertensive medications as potential causative agents in patients presenting with lichenoid eruptions, especially those with underlying autoimmune conditions.