Cutaneous findings in patients with pulmonary arterial hypertension receiving long-term epoprostenol therapy

Journal of the American Academy of Dermatology
Sarah A MyersVictor F Tapson

Abstract

Pulmonary arterial hypertension (PAH) is a rare debilitating disease characterized by an increase in pulmonary vascular resistance and progressive right ventricular failure. PAH may be primary or associated with other conditions such as collagen vascular disease, portal hypertension, and HIV. Intravenous epoprostenol improves the survival, exercise tolerance, hemodynamics, and quality of life in patients with PAH and is believed to work through multiple pathways including vasodilation, opposition of smooth-muscle hypertrophy, and inhibition of platelet aggregation. Common dose-limiting side effects are flushing, jaw pain, arthralgias, myalgias, and headache, which are attributed to the vasodilatory effects of epoprostenol. In clinical practice, patients often develop persistent rash that is distinct from the flushing associated with epoprostenol. The specific findings both on physical examination and on dermatopathology have not, however, been well described. This report describes the cutaneous and dermatopathologic findings of 12 patients who developed persistent rash while receiving long-term prostacyclin for PAH.

References

Feb 1, 1978·Circulation Research·T M FitzpatrickP A Kot
Sep 1, 1987·British Heart Journal·D HeathP Harris
Feb 1, 1996·The New England Journal of Medicine·R J BarstUNKNOWN Primary Pulmonary Hypertension Study Group
Jan 24, 2002·American Journal of Respiratory Cell and Molecular Biology·Lucie H ClappAndrew Tinker
Jul 13, 2002·Chest·Gregory S AhearnVictor F Tapson
Sep 18, 2002·Circulation·Vallerie V McLaughlinStuart Rich

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Citations

Jan 18, 2006·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·S P McKennaJ Pepke-Zaba
Sep 27, 2015·Pulmonary Pharmacology & Therapeutics·Aparna DasKristin B Highland
Jan 5, 2008·Clinical & Experimental Ophthalmology·Rod ForoozanDouglas P Marx
Jun 21, 2017·Pulmonary Circulation·Martha KingmanSandra Lombardi
May 30, 2013·Annals of Dermatology·María Luisa Martínez-MartínezRafaela Sánchez-Simón-Talero

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