Chronic Eczematous Eruptions in the Aging

Summers, Erika M.; Bingham, Colby S.; Dahle, Kevin W.; Sweeney, Carol; Jin, Ying; Sontheimer, Richard D.

doi:10.1001/jamadermatol.2013.511

Cited by 39 publications

(12 citation statements)

References 10 publications

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“…Among antimicrobials, higher rates of pruritus with penicillin antibiotics and trimethoprim–sulfamethoxazole are thought to be secondary to inflammatory skin eruptions or cholestatic liver injury [1,3]. Among cardiovascular drugs, calcium channel blockers, beta blockers, and hydrochlorothiazide are associated with pruritus from skin inflammation, while itch with ACE inhibitors is thought to result from increased levels of bradykinin [3,6,7]. In addition, the rate of pruritus observed in statins (0.67%) is significant, considering its ubiquitous use as the second most commonly prescribed medication in the study (n = 316,196).…”

Section: Discussionmentioning

confidence: 99%

Pruritus Associated with Commonly Prescribed Medications in a Tertiary Care Center

et al. 2019

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Background: Sparse data are available on rates of drug-induced pruritus, a well-recognized adverse reaction. We sought to assess relative rates of pruritus associated with commonly prescribed medications. Methods: Using the electronic medical record system EPIC, retrospective data were collected on patients seen at Johns Hopkins who received a medication of interest in a five-year period (2013–2018). Sequential criteria were used to identify the subpopulation who presented with a chief complaint of “pruritus” or diagnosis of “itching” within three months of receiving drugs. Results: We identified 9802 patients with pruritus after drug initiation and 1,085,404 patients without. A higher proportion of those with pruritus were female (70%) than those without (58%), p < 0.001. Patients in both groups were most commonly 50 to 79 years old. A higher proportion of patients with pruritus were black (40%) compared to those without (23%), p < 0.001. In this study, the highest rates of pruritus were observed with heparin (1.11%), trimethoprim-sulfamethoxazole (1.06%), and calcium channel blockers (0.92%). Psychiatric/neurologic drugs used to treat pruritus were associated with low rates of itch. Conclusions: Certain cardiovascular and antimicrobial agents are associated with increased frequencies of pruritus. This knowledge may guide providers in clinical selection of commonly used agents to minimize adverse effects associated with reduced compliance.

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Section: Discussionmentioning

confidence: 99%

Pruritus Associated with Commonly Prescribed Medications in a Tertiary Care Center

et al. 2019

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“…However, two prior case-control studies noted a possible relationship of these medications with the development of chronic eczematous eruptions in the elderly [11, 12]. In the study by Summers et al [13], patients older than 50 years who were taking the drug for at least 1 month and suffered a chronic eczematous eruption for at least 2 months were more likely to be on CCBs and thiazides compared to controls who were patients with common dermatological conditions such as actinic keratosis, basal cell carcinoma, impetigo and seborrhoeic keratoses. In another study by Joly et al [12], patients older than 60 years who suffered from a chronic eczematous eruption affecting more than 20% of the body surface for at least 3 months were more likely to be on CCBs compared to controls who were patients in private dermatology practices and inpatients with non-dermatological conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Two recent studies have shown a link between chronic use of antihypertensive drugs and the development of chronic eczematous eruptions in the elderly [12, 13]. They suggested that a proportion of these chronic eczematous eruptions could be attributed to the use of these chronic medications.…”

Section: Introductionmentioning

confidence: 99%

Idiopathic Generalized Exfoliative Dermatitis and Association with Antihypertensive Drugs and Statins: A Retrospective Case-Control Study

2019

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Background/Aims: We aim to examine the hypothesis that antihypertensive drugs and statins may be responsible for the development of idiopathic generalized exfoliative dermatitis (GED) with a case-control study. Methods: All inpatients who were hospitalized under the dermatology service at the Tan Tock Seng Hospital, Singapore, between 1 May 2013 and 31 May 2015, were analysed. Idiopathic GED cases had consistent clinical and histological features but no apparent cause despite comprehensive evaluation. Controls were randomly selected from inpatients with other dermatological conditions in a 1: 1 ratio during the same period. Their relationship was analysed using univariate (χ² or Fisher exact tests) and multivariate logistic regression analysis. Results: There were 78 cases and 83 controls. Of the 78 cases, 42 patients had a history of treatment with antihypertensive drugs or statins. Cases were not found to be more likely on angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, calcium channel blockers, thiazides or statins compared to controls (OR: 0.81; 95% CI: 0.43–1.51; p = 0.507). Conclusions: There was insufficient evidence to suggest a significant relationship between the chronic use of antihypertensive drugs or statins and idiopathic GED in this study, despite previous evidence reporting this might be so. Further case-control studies with larger sample sizes are needed to evaluate this association.

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“…Cardiovascular drugs such as anticoagulants, methyldopa, statins, CCBs, and thiazides were also found to be associated with eczematous drug eruptions [ 13 ]. Heparin and telmisartan-hydrochlorothiazide have been reported to induce BS/SDRIFE [ 14 , 15 ].…”

Section: Eczematous Drug Eruptionmentioning

confidence: 99%