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Cimetidine-induced cutaneous vasculitis.

G G Mitchell, A R Magnusson, J M Weiler

The American Journal of Medicine

|November 1, 1983

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Oral cimetidine can cause urticarial vasculitis, a type III hypersensitivity reaction. Biopsy and rechallenge confirmed this link, with symptoms resolving after drug discontinuation.

Area of Science:

Immunology
Dermatology
Pharmacology

Background:

Urticarial vasculitis is an inflammatory condition characterized by hives that persist longer than 24 hours and are associated with vasculitic changes.
Cimetidine is a histamine H2-receptor antagonist commonly used to treat conditions like peptic ulcers and gastroesophageal reflux disease.

Observation:

A patient presented with a rash consistent with urticarial vasculitis.
The rash recurred on two separate occasions upon exposure to oral cimetidine.
Skin biopsy confirmed urticarial vasculitis on both occasions.

Findings:

The patient's urticarial vasculitis resolved after discontinuing cimetidine.
This case provides biopsy-proven evidence linking oral cimetidine to urticarial vasculitis.

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The findings suggest a type III hypersensitivity reaction mediated by cimetidine.

Implications:

This report highlights a potential adverse drug reaction to cimetidine, emphasizing the importance of considering drug-induced vasculitis in differential diagnoses.
Clinicians should be aware of the possibility of cimetidine-induced urticarial vasculitis, particularly in patients with recurrent or persistent urticarial lesions.
Further research may be warranted to elucidate the precise mechanisms of cimetidine-induced type III hypersensitivity.