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Propofol Induced Subacute Cutaneous Lupus Erythematosus: A Case Report
Joseph A Schoenfeldt1, Michael A Howard1, Deeba Masood1
1From the Departments of Anesthesiology, Plastic Surgery, and Allergy and Immunology, Northwestern University, Lake Forest, Illinois.
A&A Practice
|August 24, 2023
Summary
Recurrent rashes after anesthesia were linked to propofol. Removing this drug led to successful surgeries without skin reactions, suggesting propofol-induced subacute cutaneous lupus erythematosus.
Area of Science:
- Dermatology
- Anesthesiology
- Immunology
Background:
- Drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) is a photosensitive rash.
- Propofol is a common anesthetic agent with known adverse effects.
Observation:
- A patient presented with recurrent, unexplained rashes of varying severity following multiple anesthetic exposures.
- These rashes resolved after propofol was excluded from the anesthetic regimen.
Findings:
- The patient experienced two successful surgeries under general anesthesia without any resultant rashes after propofol was removed.
- This clinical course strongly suggests a causal link between propofol exposure and the patient's dermatological reactions.
Implications:
- Propofol should be considered a potential trigger for DI-SCLE in patients with unexplained recurrent rashes post-anesthesia.
- Further investigation into propofol's immunomodulatory effects may elucidate mechanisms of DI-SCLE.
- Clinicians should maintain a high index of suspicion for drug-induced lupus when evaluating patients with post-anesthetic rashes.
