A case of probable drug-induced psoriasis to dapagliflozin

Exposure to certain drugs can trigger new-onset psoriasis or flaring of existing psoriatic disease. The clinical presentation of drug-induced psoriasis can vary, and although there are features suggestive of drug-induced psoriasis, there are currently no standardized criteria to differentiate it from conventional psoriasis. Patients may present with localized psoriasiform plaques, or variants such as palmoplantar, nail disease, or widespread erythroderma. Histopathology of drug-induced psoriasis can also be indistinguishable from conventional psoriasis but features suggestive of drug-induced include lack of suprapapillary epidermal thinning, a limited number of Munro microabscesses, and the presence of eosinophils and/or a lichenoid reaction pattern. We report a case of suspected drug-induced psoriasis due to dapagliflozin (Farxiga) in a 76-year-old man. Evidence indicating this to be a probable drug-induced reaction includes the sudden onset of symptoms; atypical pathology with the presence of eosinophils; and clearance of the lesions upon discontinuation of the suspected causative drug.