Jan 27, 2005

Complicated lichenoid drug eruption

The Australasian Journal of Dermatology
Katherine Armour, Patricia Lowe

Abstract

We report a case of severe lichenoid drug eruption with multiple possible causative agents. A hepatitis C-positive male presented with a short history of painful erosions of the vermilion, lichenoid lesions on the buccal mucosa and glans penis, and erosions and lichenification of the scrotum. In addition, he had a pruritic polymorphic eruption over the scalp, trunk and limbs, comprising psoriasiform and eczematous lesions. He had received combination therapy of pegylated interferon-alpha-2a and ribavirin, along with granulocyte colony-stimulating factor for interferon-induced leucopenia, and propranolol for portal hypertension. The former three agents were ceased 3 weeks prior to presentation, but he remained on propranolol at the initial dermatology consultation. The polymorphous clinical picture was consistent with lichenoid drug eruption, which was confirmed on histology. The papulosquamous eruption responded quickly to 2 weeks of oral prednisone 25 mg daily, which was tapered to 1 mg over 3 months and then ceased. The mucosal lesions were slow to improve and required the addition of tacrolimus 0.03% solution t.d.s. for complete resolution.

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Citations

Mentioned in this Paper

Granulocyte Colony-stimulating Factor Binding
Entire Scalp
Histology Procedure
Scrotum
Glans Penis
Mucositis
Granulocyte Colony-Stimulating Factor
Proteins, Recombinant DNA
Benign Neoplasm of Scrotum
Human leukocyte interferon

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