Candesartan-Associated Lichenoid Drug Eruption.
Kazuyoshi Iijima1, Yoshihito Mima2
1Department of Dermatology, Teikyo Mizonokuchi Hospital, Kanagawa, JPN.
Cureus
|July 14, 2025
Summary
Lichenoid drug eruption (LDE) is a rare adverse reaction. This case highlights candesartan as a potential cause, emphasizing prompt diagnosis and drug withdrawal for resolution.
Area of Science:
- Dermatology
- Pharmacology
Background:
- Lichenoid drug eruption (LDE) is an uncommon adverse drug reaction.
- Angiotensin II receptor blockers (ARBs) are rarely implicated in LDE.
Observation:
- A 67-year-old woman developed pruritic, violaceous papules and plaques.
- The eruption appeared two years after initiating candesartan, an ARB.
- Skin biopsy confirmed lichenoid drug eruption.
Findings:
- Candesartan was identified as the likely causative agent for the LDE.
- Discontinuation of candesartan and substitution with amlodipine led to gradual resolution.
- No recurrence was observed at 12-month follow-up.
Implications:
- This case underscores diagnostic challenges of LDE, including long latency periods and mimicry of idiopathic lichen planus.
- Low sensitivity of confirmatory tests like patch testing and drug-induced lymphocyte stimulation testing is noted.
- Physicians should maintain a high suspicion for drug-induced lichenoid reactions, irrespective of recent medication changes, for effective management.
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