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Panniculitis in association with apomorphine infusion

K M Acland1, A Churchyard, C L Fletcher

  • 1Department of Dermatology, University College Hospitals Trust, London, UK.

The British Journal of Dermatology
|May 15, 1998
PubMed
Summary

Histopathology revealed panniculitis in Parkinson's patients using apomorphine. Skin biopsies showed inflammation, but patch tests and IgE levels were normal, suggesting localized reactions rather than systemic allergies.

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Area of Science:

  • Dermatology
  • Neurology
  • Pathology

Background:

  • Parkinson's disease (PD) treatment often involves dopamine agonists like apomorphine.
  • Continuous subcutaneous apomorphine infusion is used for advanced PD management.
  • Cutaneous nodules are an observed side effect in some patients.

Purpose of the Study:

  • To investigate the histopathology of skin nodules in patients with Parkinson's disease receiving continuous subcutaneous apomorphine.
  • To determine the aetiology of these cutaneous reactions.

Main Methods:

  • Recruitment of ten Parkinson's patients experiencing cutaneous nodules.
  • Skin biopsies for histopathological examination.
  • Questionnaires, full blood count, serum IgE levels, and patch testing with apomorphine and its preservative.

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Main Results:

  • All skin biopsies demonstrated florid panniculitis.
  • Histological findings included predominantly eosinophilic, lymphocytic, or neutrophilic inflammation.
  • Patch testing results were negative in all tested patients, and serum IgE levels were within the normal range.

Conclusions:

  • The cutaneous nodules associated with continuous subcutaneous apomorphine in Parkinson's disease are characterized by panniculitis.
  • The aetiology does not appear to be related to systemic allergic reactions (IgE-mediated) or direct hypersensitivity to apomorphine via patch testing.
  • Further investigation into localized inflammatory mechanisms is warranted.