Beta-Blocker-Induced Erythrodermic Psoriasis: A Case Report

Voloshyna, Diana; Ullah, Saad Ehsan; Jahan, Nusrat; Yadlapalli, Sai Sreya; Zahoor, Mohammad Munim; Shams, Yumna; Sathish, Meenakshi; Sandhu, Qudsia I; Saleem, Farhan

doi:10.7759/cureus.29809

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…What is more, drugs commonly used in comorbidities could also induce erythroderma, according to some studies [23][24][25][26][27][28]. Cases of β-blocker-induced erythroderma (e.g., bisoprolol, metoprolol) have also been reported in the literature [29,30]. Moreover, erythroderma can (rarely) be caused by metformin, insulin, and other diabetes drugs [25][26][27][28].…”

Section: Drug Reactionmentioning

confidence: 99%

Erythroderma: A Retrospective Study of 212 Patients Hospitalized in a Tertiary Center in Lower Silesia, Poland

Kliniec,

Snopkowska,

Łyko

et al. 2024

JCM

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Erythroderma is a condition characterized by erythema affecting at least 90% of the skin surface area. It can be caused by various underlying conditions. Due to nonspecific clinical and laboratory findings, determining the cause may pose a challenge. In the retrospective study, we identified 212 patients hospitalized for erythroderma in the Department of Dermatology, Venereology, and Allergology at Wroclaw Medical University between January 2012 and March 2022. Clinical, laboratory, and histopathological features, as well as the management of patients, were studied. The median age of adults was 61 years (IQR = 47–68). The most common causes of erythroderma were psoriasis (n = 49, 24.01%), followed by atopic dermatitis (AD) (n = 27, 13.23%), and cutaneous T-cell lymphomas (CTCL) (n = 27, 13.23%). Despite laboratory tests and histopathological examination, the etiology of erythroderma remained undetermined in 39 cases (19.12%). In 70.59% of patients, it was the first episode of erythroderma, while 29.41% experienced a recurrent episode. Regardless of the etiology of erythroderma, patients were most frequently treated with systemic antihistamines (146 cases, 71.57%) and systemic steroids (132 cases, 64.71%). Patients with idiopathic erythroderma constitute the greatest diagnostic and therapeutic challenge, requiring particularly thorough evaluation.

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Section: Drug Reactionmentioning

confidence: 99%

Erythroderma: A Retrospective Study of 212 Patients Hospitalized in a Tertiary Center in Lower Silesia, Poland

Kliniec,

Snopkowska,

Łyko

et al. 2024

JCM

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“…Rising trend of BBs prescription around the world results in the increasing related side effects, particularly, dermatological reactions (such as erythrodermic psoriasis) 79 . In this respect, the BBs can flare the preexisting PsD in one hand, and induce the de novo PsD in naïve individuals on the other hand.…”

Section: Possible Causesmentioning

confidence: 99%

Causes of Autoimmune Psoriasis and Associated Cardiovascular Disease: Roles of Human Endogenous Retroviruses and Antihypertensive Drugs—A Systematic Review and Meta-analysis

Rezabakhsh,

Manjili,

Hosseinifard

et al. 2023

Preprint

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Current treatments are ineffective to cure or prevent occurrences of autoimmune psoriasis and psoriatic cardiovascular disease/CVD. Psoriasis is associated with deregulated expressions of human endogenous retroviruses (ERVs) variants. ERV transcripts and proteins are detected in lesioned biopsies—without assembled viral particles—in addition to antibody and T-cell responses against ERV-K dUTPase. In persons living with HIV-1, manifestations of psoriasis are exacerbated variably. These may depend on multiple factors, differences in ERVs expressions, subtypes of HIV-1, and/or epigenetics. This article represents a quantitative risk assessment and meta-analysis approach with an attempt to assess causality. We surmise that mutated ERVs trigger aberrant proliferation and differentiation of keratinocytes, which in turn induce proinflammatory polarization. Independent risk factors and/or covariates with a range of relative risk/RR ratios appear to significantly impact the development of autoimmune psoriasis or immune intolerance, plausibly through ERVs genes activity. Given the antihypertensive drug’s potential in psoriasis development, a probable role in promising either ERVs activation or perturbations in epigenetic factors is questionable. Although the correlational nature of the data based on RR ratios prevents making robust conclusions, we reckon that the likelihood of attributable risk factors for certain antihypertensive drugs may stem from their pleiotropic effects or potentials for inducing ERV-mediated dysregulation of keratinocytes and/or endothelial cells. These findings expand our knowledge regarding ERV activations and HIV-1, antihypertensive drugs use, and incidents of psoriatic disease, and call for exploring cell-specific therapies aimed at blocking or reversing mutated ERVs gene activity toward attaining stable remissions in psoriasis and associated CVD.

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Beta-Blocker-Induced Erythrodermic Psoriasis: A Case Report

Cited by 2 publications

References 10 publications

Erythroderma: A Retrospective Study of 212 Patients Hospitalized in a Tertiary Center in Lower Silesia, Poland

Erythroderma: A Retrospective Study of 212 Patients Hospitalized in a Tertiary Center in Lower Silesia, Poland

Causes of Autoimmune Psoriasis and Associated Cardiovascular Disease: Roles of Human Endogenous Retroviruses and Antihypertensive Drugs—A Systematic Review and Meta-analysis

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