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Enalapril-associated erythema and vasculitis
P R Carrington1, I D Sanusi, S Zahradka
1Department of Dermatology, Louisiana State University School of Medicine, Shreveport 71130-3932.
Cutis
|February 1, 1993
Summary
Angiotensin-converting enzyme inhibitors like enalapril can cause skin reactions. Dosage adjustments may help manage these cutaneous eruptions in patients.
Area of Science:
- Pharmacology
- Dermatology
- Nephrology
Background:
- The expanding pharmacopeia necessitates clinician awareness of drug metabolism and effects.
- Angiotensin-converting enzyme (ACE) inhibitors impact vasoactive substance deactivation.
- Interactions between systems like ACE and kininase II can lead to adverse events.
Observation:
- A patient with renal failure secondary to diabetes developed a cutaneous eruption.
- The eruption presented as vasculitis and maculopapular erythema.
- Enalapril, an ACE inhibitor, was administered to the patient.
Findings:
- ACE inhibitors can cause a range of polymorphic cutaneous eruptions.
- The patient's reaction is suspected to be an ACE inhibitor-induced eruption.
- Pathogenetic mechanisms underlying these side effects are reviewed.
Implications:
- Cutaneous side effects associated with ACE inhibitors are common.
- These adverse effects are often dose-dependent.
- Lowering the ACE inhibitor dosage can manage or resolve these reactions.