Macular‐type cutaneous adverse reaction due to atezolizumab and pembrolizumab

Acute generalised exanthematous pustulosis (AGEP) is a severe cutaneous adverse reaction characterised by the appearance of erythematous plaques and papules with overlying non-follicular pinpoint pustules. Drugs are the cause of AGEP in approximately 90% of cases. The most common causes include anti-infective agents (aminopenicillins, quinolones, antibacterial sulfonamides and terbinafine), antimalarials and diltiazem. To the best of our knowledge, to date there has only been one report of hydrochlorothiazide-induced AGEP. There has never been a case report of losartan-induced AGEP. Here, we present a case of AGEP that is the second case purportedly caused by hydrochlorothiazide.

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Clinical and pathogenic aspects of the severe cutaneous adverse reaction epidermal necrolysis (EN)

Journal of the European Academy of Dermatology and Venereology ◽

10.1111/jdv.16339 ◽

2020 ◽

Vol 34 (9) ◽

pp. 1957-1971 ◽

Cited By ~ 3

Author(s):

E.C. Kuijper ◽

L.E. French ◽

C.P. Tensen ◽

M.H. Vermeer ◽

J.N. Bouwes Bavinck

Keyword(s):

Adverse Reaction ◽

Cutaneous Adverse Reaction

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Cutaneous adverse reaction to imatinib in a case of childhood chronic myeloid leukemia

Pediatric Blood & Cancer ◽

10.1002/pbc.28490 ◽

2020 ◽

Vol 67 (12) ◽

Cited By ~ 1

Author(s):

Megha Saroha

Keyword(s):

Adverse Reaction ◽

Chronic Myeloid Leukemia ◽

Myeloid Leukemia ◽

Cutaneous Adverse Reaction

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Pustular Psoriasis and Acute Generalized Exanthematous Pustulosis

Medicina ◽

10.3390/medicina57101004 ◽

2021 ◽

Vol 57 (10) ◽

pp. 1004

Author(s):

Morgan Sussman ◽

Anthony Napodano ◽

Simo Huang ◽

Abhirup Are ◽

Sylvia Hsu ◽

...

Keyword(s):

Adverse Reaction ◽

Clinical Course ◽

Pustular Psoriasis ◽

Topical Steroids ◽

Inflammatory Disorder ◽

Acute Generalized Exanthematous Pustulosis ◽

Cutaneous Adverse Reaction ◽

History Of ◽

Exanthematous Pustulosis ◽

Crucial Part

The similarity between pustular psoriasis (PP) and acute generalized exanthematous pustulosis (AGEP) poses problems in the diagnosis and treatment of these two conditions. Significant clinical and histopathologic overlap exists between PP and AGEP. PP is an inflammatory disorder that has numerous clinical subtypes, but all with sterile pustules composed of neutrophils. AGEP is a severe cutaneous adverse reaction that is also characterized by non-follicular sterile pustules. Clinical features that suggest a diagnosis of PP over AGEP include a history of psoriasis and the presence of scaling plaques. Histologically, eosinophilic spongiosis, vacuolar interface dermatitis, and dermal eosinophilia favor a diagnosis of AGEP over PP. Importantly, PP and AGEP vary in clinical course and treatment. PP treatment involves topical steroids, oral retinoids, and systemic immunosuppressants. Newer therapies targeting IL-36, IL-23, IL-1, and PDE-4 have been investigated. The removal of the offending agent is a crucial part of the treatment of AGEP.

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Long induction of tolerance to imatinib

BMJ Case Reports ◽

10.1136/bcr-2020-237069 ◽

2020 ◽

Vol 13 (12) ◽

pp. e237069

Author(s):

Leyla Bojanini ◽

Steven Attia ◽

Haesuk Heagney ◽

Alexei Gonzalez-Estrada

Keyword(s):

Adverse Reaction ◽

Kinase Inhibitor ◽

Gastrointestinal Stromal Tumour ◽

Hypersensitivity Reactions ◽

Imaging Studies ◽

Cutaneous Side Effects ◽

Cutaneous Adverse Reaction ◽

Solid Malignancies ◽

History Of ◽

Induction Of Tolerance

Imatinib is used to treat several haematological and solid malignancies. Cutaneous side effects could often limit the use of this medication. We present a case of a 62-year-old woman with a history of a gastrointestinal stromal tumour that developed a delayed cutaneous adverse reaction 10 days after starting imatinib 400 mg daily. She developed the same symptoms with reintroduction at a dose of 100 mg and with an alternative tyrosine kinase inhibitor, nilotinib 50 mg/day. Given that imatinib was considered her best treatment, she underwent a long induction of drug tolerance (IDT) protocol to imatinib. Patient tolerated the medication without further reactions for 6 months and had improvement of her cancer per last imaging studies. IDT should be considered in delayed hypersensitivity reactions to imatinib after a failed reintroduction of the drug or when no other equally effective agents are available.

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Unusual cutaneous adverse reaction to omalizumab in acu

10.26226/morressier.5acc8ad0d462b8028d89acc1 ◽

2018 ◽

Author(s):

LUZ MARINA CASTELLANOS RUIZ

Keyword(s):

Adverse Reaction ◽

Cutaneous Adverse Reaction

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DRESS syndrome: an important differential for eosinophilia with systemic organ dysfunction

BMJ Case Reports ◽

10.1136/bcr-2020-234251 ◽

2020 ◽

Vol 13 (5) ◽

pp. e234251 ◽

Cited By ~ 1

Author(s):

Whoasif Mukit ◽

Richard Cooper ◽

Harmesh Moudgil ◽

Nawaid Ahmad

Keyword(s):

Adverse Drug Reaction ◽

Adverse Reaction ◽

Drug Reaction ◽

Clinical Response ◽

Organ Dysfunction ◽

Patient Harm ◽

Dress Syndrome ◽

Cutaneous Adverse Reaction ◽

Drug Rash ◽

Systemic Symptoms

Drug rash occurring with eosinophilia and systemic symptoms syndrome is a potentially fatal adverse drug reaction that requires immediate action in order to minimise patient harm. Initially implicated with the use of anticonvulsants, it has also been shown to be caused by many other medications but less frequently with vancomycin. Patients typically present with fever, lymphadenopathy, eosinophilia and systemic organ dysfunction. Diagnosis is aided using probability calculators such as RegiSCAR (Registry of Severe Cutaneous Adverse Reaction), as well as clinical response on removing the responsible medication. Here, we present a case without any systemic organ dysfunction that improved with withdrawal of the offending drug vancomycin.

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