Bullous Reactions Associated With COX-2 Inhibitors

Tatu, Alin Laurențiu; Nwabudike, Lawrence Chukwudi

doi:10.1097/mjt.0000000000000569

Cited by 17 publications

(14 citation statements)

References 28 publications

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“…But a dermatological one, in particular, has been gaining attention as of late. Although the mechanism is not fully understood yet, the use of beta-blockers is known to exacerbate pre-existing psoriasis, as well as precipitating it de novo [ 4 , 5 ]. The first scenario of exacerbation of psoriasis is defined as the cessation of the progression upon withdrawal of the agent in either pre-existing lesions or new lesions in uninvolved skin.…”

Section: Introductionmentioning

confidence: 99%

Mechanisms of Beta-Blocker Induced Psoriasis, and Psoriasis De Novo at the Cellular Level

Awad

Sakhamuru

Kambampati

et al. 2020

Cureus

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Beta-blockers are a commonly prescribed medication, but the increase in use goes hand in hand with increasing side effects; one of particular interest lately has been its dermatological reactions. Although rare, beta-blockers can exacerbate pre-existing psoriasis and also cause de novo psoriasis in patients naïve to the disease. The mechanism by which this occurs is still unclear, although numerous articles have been published throughout the years as to how this unusual effect takes place. The most common mechanism suggests that beta-blockers cause intracellular changes in calcium, affecting both keratinocyte proliferation and granulocyte function via decreased cyclic adenosine monophosphate (cAMP) levels. Several inflammatory mediators are known to play a role, as well as reduced expression and desensitization of the beta-adrenergic receptor itself. We discuss these posed pathways in-depth and how each contributes to the worsening or formation of new psoriasis. With this knowledge, future physicians may be more mindful of this side effect should it occur, and why they occur, to better manage our patients on this widely used medication.

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Section: Introductionmentioning

confidence: 99%

Mechanisms of Beta-Blocker Induced Psoriasis, and Psoriasis De Novo at the Cellular Level

Awad

Sakhamuru

Kambampati

et al. 2020

Cureus

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“…Isolated cutaneous reactions appear to be primarily due to non-IgE mediated anaphylaxis, and severe side effects such as arterial hypotension, bronchospasm, are due to type IgE mediated allergy mechanisms ( 1 , 7 , 8 ). Other side effects may be induced by first cellular mechanisms interleukin-modulated because of topical medication or may occur on common medication and may be locally complicated ( 9-13 ).…”

Section: Discussionmentioning

confidence: 99%

“…As an intraanesthetic sensitivity response, the incidence was reported to be between 1/1,250 and 1/13,000 anesthetic interventions ( 8-10 ). Other studies have reported the incidence of anaphylactic reactions as being between 1/4,000 to 1/25,000( 4 ) and 1/5,000 of these are caused by neuro-muscular blockers ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Postanesthetic skin erythema due to succinylcholine versus atracurium

et al. 2020

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Intraoperative anaphylactic reactions may range from mild, erythema-like to anaphylactic shock, with tension crash and bronchospasm. The substances considered to be most responsible for the occurrence of intraoperative allergic reactions are neuromuscular blocking agents, antibiotics and latex. Recent studies have identified a new receptor, Mas-Related G-Protein-coupled Receptor X2 (MRGPRX2), considered as a target for some neuromuscular blockers such as atracurium, rocuronium or fluoroquinolone, resulting in pseudoallergic or anaphylactoid reactions. Induction of anesthesia can use both depolarizing myorelaxants, useful especially in emergency situations, in the patient with gastric plenitude or at high risk of intubation, and non-depolarizing myorelaxants such as atracurium, cisatracurium and rocuronium. Succinylcholine has a short time of action and it is rapidly metabolized. Atracurium, although having a slightly longer time to action, has the benefit of a low risk of increased levels of potassium in blood, which is extremely important in patients with cardiac pathology or associated kidney diseases. The present study compared the side effects of systemic anesthesia with succinylcholine vs. atracurium.

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“…Antiseptics are used in various medical and surgical conditions [64][65][66][67][68][69][70][71][72]. Their role is to inhibit the bacterian,viral pathologic proliferation but also they act by inhibing normal microbiota or endosymbionts [73][74][75][76][77][78][79][80][81][82][83].…”

Section: Discussionmentioning

confidence: 99%

Undesirable Effects of Some Topical Antiseptics Chemical, pharmacological and dermatological aspects

Tatu¹,

Ardeleanu²,

Elisei³

et al. 2019

Rev. Chim.

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Topical antiseptics are a diverse group of agents that are widely used in medicine for the antimicrobial properties. Despite their long history and broad application, caution must be exercised in their use, especially in the pediatric age group, as various cutaneous reactions ranging from hypersensitivity to urticarial to skin necrosis have been reported. The use of topical antiseptics in pediatrics has also been associated with systemic reactions, which depend on the antiseptic in question. Antiseptics such as chlorhexidine, povidon iodine, methylene blue, gentian violet, silver nitrate, boric acid, Castellani solution, alcohol and chloramines have been reviewed. It is essential that physicians bear in mind the possible adverse effects that may follow topical antiseptic use, as this facilitates prevention and also timely intervention if, and when, they occur.

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Bullous Reactions Associated With COX-2 Inhibitors

Cited by 17 publications

References 28 publications

Mechanisms of Beta-Blocker Induced Psoriasis, and Psoriasis De Novo at the Cellular Level

Mechanisms of Beta-Blocker Induced Psoriasis, and Psoriasis De Novo at the Cellular Level

Postanesthetic skin erythema due to succinylcholine versus atracurium

Undesirable Effects of Some Topical Antiseptics Chemical, pharmacological and dermatological aspects

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