Allergic contact dermatitis due to lansoprazole, a proton pump inhibitor

Vilaplana, J.; Romaguera, C.

doi:10.1034/j.1600-0536.2001.440107-14.x

Cited by 43 publications

(9 citation statements)

References 17 publications

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“…Five cases of occupational airborne contact dermatitis caused by lansoprazole, pantoprazole, and omeprazole in pharmaceutical industry workers have been reported so far [11,[62][63][64][65].…”

Section: Delayed Hypersensitivity Reactionsmentioning

confidence: 99%

Hypersensitivity Reactions to Proton Pump Inhibitors

Lombardo

Bonadonna

2015

Curr Treat Options Allergy

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Proton pump inhibitors I Drug allergy I Anaphylaxis I Adverse drug reaction I Drug hypersensitivity Opinion Statement Proton pump inhibitors (PPIs) are drugs widely used and usually well tolerated. However, cases of immediate or cell-mediated hypersensitivity reactions due to all PPIs, with the exception of the newest dexlansoprazole and tenatoprazole, have been described. In the case of suspected IgE-mediated reaction skin test (prick test and intradermal test) with nonirritant drug concentration published is safe and highly specific (100 %) with a PPV of 100 %. Thus, oral provocation test should be performed only in case of negative results to rule out definitely the diagnosis. In the case of possible cell-mediated hypersensitivity reaction, a delayed reading of intradermal test, at least after 24 and 48 h, and patch test should be performed, but we do not have standardized procedures so far. Cross-reactivity among all PPIs is not a dogma, in fact, three patterns of cross-reactivity have been described. Thus, in patients with ascertained allergy to a PPI, a complete evaluation (skin test and oral provocation test) of all five PPIs available helps to identify a safe alternative.

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Section: Delayed Hypersensitivity Reactionsmentioning

confidence: 99%

Hypersensitivity Reactions to Proton Pump Inhibitors

Lombardo

Bonadonna

2015

Curr Treat Options Allergy

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“…The epidermal changes in this study were unpredictable when considering the pharmacological effects of the compound. However, for proton pump inhibitors, fetal TEN due to lansoprazole, erythrodermic reactions due to omeprazole and lansoprazole and allergic contact dermatitis due to lansoprazole have been reported in human patients [14][15][16] . Although the information obtained in the present study is limited because of its preliminary properties, if involvement of an immune-related mechanism is confirmed, the epidermal necrosis in the dog could become a useful animal model for mechanistic studies of drug-induced hypersensitivity reactions, including cutaneous drug reactions.…”

mentioning

confidence: 99%

Erythroderma and Epidermal Necrosis Induced by a Type of Proton Pump Inhibitor in Beagle Dogs

et al. 2007

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Reddish skin covering the entire body (erythroderma) was observed in a preliminary one-week oral toxicity study of a type of proton pump inhibitor in Beagle dogs. Histologically, full-thickness epidermal necrosis accompanied by apoptosis, evidenced by an immunohistochemical positive reaction to cleaved caspase-3, and detachment of the epidermis were observed in the skin. In the epidermis and upper dermis, a slight infiltration of mononuclear cells was seen, which was predominantly positive for MAC387 (macrophages) and partly positive for CD3 (T lymphocytes). These findings have some similarities to drug-induced severe skin reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) and may represent incipient changes of such lesions. The skin lesions observed in these dogs are being considered as a potential animal model of cutaneous drug reactions. (J Toxicol Pathol 2007; 20: 257-261)

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“…This is further supported by the literature which, to date, only has four case reports that describe an association between PPI and TEN (Table 1). Other severe skin reactions also associated with PPI include subacute cutaneous lupus erythematosus, 12 lichenoid drug eruption, 13 allergic contact dermatitis 14 and angioedema. 15 However, none of these conditions have the high morbidity and mortality associated with TEN.…”

Section: Discussionmentioning

confidence: 99%

Toxic epidermal necrolysis and neutropaenia: Complications of omeprazole

Thakor¹,

Burke²,

Handfield‐Jones³

et al. 2009

Aust J Dermatology

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Worldwide, proton pump inhibitors (PPI) are one of the most frequently prescribed drugs; however, up to 70% of patients taking these drugs have no appropriate indication. Although PPI are relatively well tolerated, they are not free from side-effects and several life-threatening complications are associated with them. In the present report, a 43-year-old woman presented to her general practitioner with an erythematous rash over her face and chest, having been started on omeprazole for chronic abdominal bloating. Over the next 24 h she became increasingly unwell and was admitted to hospital with shortness of breath, pyrexia and the rash spreading over her back, arms and legs. Vesicles had now started to appear within the erythematous regions over her upper body and within 24 h the rash became confluent and desquamative, spreading to involve her entire body. A diagnosis of toxic epidermal necrolysis (TEN) was made. Despite supportive treatment within a critical care setting, she became neutropaenic and her skin loss became more extensive, resulting in 95% epidermal detachment. This case highlights that TEN is a life-threatening condition associated with a high incidence of morbidity and mortality. Optimal management requires early diagnosis and transfer to a specialized unit. Clinicians need to be aware that PPI are not free from side-effects and that their routine prescription should be strongly discouraged.

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Allergic contact dermatitis due to lansoprazole, a proton pump inhibitor

Cited by 43 publications

References 17 publications

Hypersensitivity Reactions to Proton Pump Inhibitors

Hypersensitivity Reactions to Proton Pump Inhibitors

Erythroderma and Epidermal Necrosis Induced by a Type of Proton Pump Inhibitor in Beagle Dogs

Toxic epidermal necrolysis and neutropaenia: Complications of omeprazole

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