Adverse Dermatologic Effects of Cardiovascular Drug Therapy: Part I

Abstract

Cardiovascular disease is common, affecting an increasing number of persons as the population ages. To combat this growing health problem, physicians use a multitude of medications in the treatment of their patients. Although pharmacologic therapy greatly enhances quality of life for a majority of patients, there is always the potential for an unfavorable reaction. For example, cardiovascular drugs can induce a vast array of adverse dermatologic responses. This article reviews the various cutaneous reaction patterns that can occur as a result of treatment with Class I and II antiarrhythmic agents.

Photosensitizing antihypertensive drug use and risk of cutaneous squamous cell carcinoma

“…14,15,18,22 ACE inhibitors and ARBs have been associated with a reduced risk of keratinocyte cancers in some studies 17,21 and an increased risk in others. 22,24 Beta blockers, which are not widely recognized as photosensitizing, [1][2][3][4][5] have been associated with an increased risk of lip cancer and SCC in some studies. 14,20 To our knowledge, the present study is the first to examine cSCC risk associated with the use of alpha blockers and central agonists.…”

“…A computerized prescription record system has tracked all prescriptions dispensed within KPNC since August 1994. Based on a review of the literature, ADs were classified as photosensitizing [alpha‐2 receptor agonists and diuretics (loop, potassium‐sparing, thiazide and combination)], nonphotosensitizing [alpha blockers, beta blockers, central agonists and angiotensin receptor blockers (ARBs)] or unknown [angiotensin converting enzyme (ACE) inhibitors, calcium channel blockers (CCBs), vasodilators and other combinations] . Exposure was defined as two or more filled prescriptions for a given medication during the study period.…”

“…Based on a review of the literature, ADs were classified as photosensitizing [alpha-2 receptor agonists and diuretics (loop, potassium-sparing, thiazide and combination)], nonphotosensitizing [alpha blockers, beta blockers, central agonists and angiotensin receptor blockers (ARBs)] or unknown [angiotensin converting enzyme (ACE) inhibitors, calcium channel blockers (CCBs), vasodilators and other combinations]. [1][2][3][4][5][6][7] Exposure was defined as two or more filled prescriptions for a given medication during the study period. While a single prescription for a photosensitizing AD could theoretically increase cSCC risk, two or more filled prescriptions were required to minimize the chance of including patients who filled a prescription but never took the medication.…”

“…Many commonly used medications, including certain antihypertensive drugs (ADs), are photosensitizing, heightening reactivity of the skin to sunlight . The photosensitizing properties of these medications are related to their distinct chemical structures that allow for the absorption of ultraviolet radiation (UVR) .…”

“…Many commonly used medications, including certain antihypertensive drugs (ADs), are photosensitizing, heightening reactivity of the skin to sunlight. [1][2][3][4][5][6][7] The photosensitizing properties of these medications are related to their distinct chemical structures that allow for the absorption of ultraviolet radiation (UVR). [7][8][9][10] In the presence of UVR, photosensitizing medications may act as carcinogens by triggering phototoxic reactions, which cause acute DNA damage, and photoallergic reactions, which produce chronic inflammation.…”