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[Captopril induced lichenoid eruption].

P Bravard, M Barbet, D Eich

    Annales De Dermatologie Et De Venereologie
    |January 1, 1983
    PubMed
    Summary
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    Captopril can cause a rare skin reaction called lichenoid eruption, appearing as localized or widespread lesions. This reaction, potentially dose-related and appearing late in therapy, improved after discontinuing Captopril.

    Area of Science:

    • Dermatology
    • Pharmacology
    • Immunodermatology

    Background:

    • Captopril, an angiotensin-converting enzyme (ACE) inhibitor, is widely used for hypertension.
    • Cutaneous adverse drug reactions are common, but lichenoid eruptions are less frequently reported with ACE inhibitors.

    Observation:

    • Three cases of Captopril-induced lichenoid eruption are presented, a reaction not previously documented.
    • The eruption presented as violaceous papules or plaques, localized in two cases and disseminated in one.
    • While the oral mucosa was spared, other mucous membranes, like the glans penis, could be affected.

    Findings:

    • The cutaneous adverse reaction appeared dose-related and could manifest late in therapy, even after six months.
    • Histopathology showed lichenoid features with sparse dermal infiltrate; immunofluorescence revealed anti-IgM and C4 deposits on dermal colloid bodies in one case.

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  • Discontinuation of Captopril led to clinical improvement in all reported cases.

    • Implications:

    • This study highlights a novel cutaneous adverse effect of Captopril, emphasizing the need for vigilance in patients on this medication.
    • The similar chemical structures of Penicillamine, Pyritinol, and Captopril raise questions about a potential shared mechanism in inducing lichenoid eruptions.
    • Further research is warranted to elucidate the specific immunopathogenesis and to identify potential cross-reactivity among structurally similar drugs.