Acute localized exanthematous pustulosis caused by enoxaparin

Mozafari, Nikoo; Farjami, Mohammad; Jamali, Elena; Rostami, Hossein Nazary; Ketabi, Yasaman

doi:10.1111/ced.14805

Cited by 4 publications

(1 citation statement)

References 5 publications

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“…21,22 Similarly, only 3 case reports have reported enoxaparin in association with AGEP and one has associated this drug with DRESS. [23][24][25][26] There has been an association between these heparins with other type IV hypersensitivity reactions including urticariform plaques and eczema-like infiltrated plaques, suggesting perhaps there is an immune component to these drugs at play that has not been fully described. 27,28 However, because heparins are some of the most commonly used drugs in a hospital setting, it is important to note that this could result in falsely elevated ROR values in cases where the SCAR occurred while the patient was hospitalized.…”

Section: Our Scars Analysismentioning

confidence: 99%

Medication Associations With Severe Cutaneous Adverse Reactions: A Case/Non-Case Analysis Using the FDA Adverse Event Reporting System

Godfrey,

Jedlowski,

Thiede

2024

J Cutan Med Surg

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Background: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP) are potentially life-threatening severe cutaneous adverse reactions (SCARs). Although the classical causal agents of SCARs (antibiotics, anticonvulsants, nonsteroidal anti-inflammatory drugs, and allopurinol) are well characterized, there has been little update to this list to account for newly marketed medications. Objective: To provide an updated and stratified list of medications with significant reporting odds ratios (RORs) of SCARs. Methods: A case/non-case analysis using the United States FDA Adverse Event Reporting System was performed. Results: As expected, the prototypical medication classes made up the majority of reported cases of SJS, TEN, AGEP, and DRESS (77%, 64%, 75%, and 72%, respectively). In addition, several infrequently or previously undescribed classes/medications implicated in SCARs were identified to have significant ROR signals, including acetylcysteine, anticoagulants, diuretics, immunotherapies, proton pump inhibitors, antivirals, and antifungals. Among these reported for SJS were acetylcysteine (ROR: 64.38) and fluconazole (ROR: 17.13). For TEN, we identified furosemide (ROR: 26.32), spironolactone (ROR: 14.45), fluconazole (ROR: 30.21), amphotericin B (39.06), and acetylcysteine (ROR: 93.12). For AGEP, we identified acyclovir (ROR: 61.72), valacyclovir (ROR: 30.76), and enoxaparin (ROR: 27.37). For DRESS, we identified vemurafenib (ROR: 17.35), acyclovir (ROR: 30.63), abacavir (ROR: 26.62), raltegravir (ROR: 23.27), and valacyclovir (ROR: 21.77) to have strong reporting odds. Conclusion: Our analysis provides an updated tool for physicians to reference when identifying suspected SCARs and a basis for future studies to investigate atypical medication causality.

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Section: Our Scars Analysismentioning

confidence: 99%

Medication Associations With Severe Cutaneous Adverse Reactions: A Case/Non-Case Analysis Using the FDA Adverse Event Reporting System

Godfrey,

Jedlowski,

Thiede

2024

J Cutan Med Surg

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Acute Generalized Exanthematous Pustulosis: Clinical Features, Differential Diagnosis, and Management

et al. 2023

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Acute generalized exanthematous pustulosis (AGEP) is a rare, acute, severe cutaneous adverse reaction mainly attributed to drugs, although other triggers, including infections, vaccinations, ingestion of various substances, and spider bites, have also been described. AGEP is characterized by the development of edema and erythema followed by the eruption of multiple punctate, non-follicular, sterile pustules and subsequent desquamation. AGEP typically has a rapid onset and prompt resolution within a few weeks. The differential diagnoses for AGEP are broad and include infectious, inflammatory, and drug-induced etiologies. Diagnosis of AGEP depends on both clinical and histologic criteria, as cases of overlap with other disease processes have been reported. Management includes removal of the offending drug or treatment of the underlying cause, if necessary, and supportive care, as AGEP is a self-limited disease. This review aims to provide an overview and update on the epidemiology, pathogenesis, reported precipitating factors, differentials, diagnosis, and management of AGEP.

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Enoxaparin sodium

2022

Reactions Weekly

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Acute localized exanthematous pustulosis caused by enoxaparin

Cited by 4 publications

References 5 publications

Medication Associations With Severe Cutaneous Adverse Reactions: A Case/Non-Case Analysis Using the FDA Adverse Event Reporting System

Medication Associations With Severe Cutaneous Adverse Reactions: A Case/Non-Case Analysis Using the FDA Adverse Event Reporting System

Acute Generalized Exanthematous Pustulosis: Clinical Features, Differential Diagnosis, and Management

Enoxaparin sodium

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