Drug-induced anti-Ro positive subacute cutaneous lupus in a man treated with olmesartan

Gray, Taylor; Segars, Kelly; Farsi, Maheera; Ross, Risa; Miller, Richard I.

doi:10.5070/d32512046719

Cited by 3 publications

(3 citation statements)

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“…In some individuals, photosensitive drugs such as hydrochlorothiazide, terbinafine, and etanercept can trigger cutaneous LE in photoexposed areas 7 , particularly in patients who had already LE serological markers before drug exposure 21 . Apart from keratinocyte necrosis/apoptosis, photosensitive drugs increase Ro/ SSA expression on the surface of keratinocytes, as in idiopathic subacute CLE, with consequent increased production of anti-Ro/SSA antibodies and cytotoxicity against these keratinocytes that express the Ro antigen on their surface 22 .…”

Section: Pathogenesis Of Di-clementioning

confidence: 99%

“…1 and 2), mainly on photoexposed areas, or occasionally in more protected areas 34 . An atypical and more widespread lesion distribution 35 , concomitant bullous and target lesions, vasculitis/purpura 22 , and erythema nodosum 26 should raise the suspicion of a drug-induced case, as well as a change in the phenotype of the disease 5 .…”

Section: Di-clementioning

confidence: 99%

“…Differences between the histology of the idiopathic form of CLE and the drug-induced form have already been suggested, but studies are not concordant. Both forms are associated with focal vacuolization of the epidermal basal layer, perivascular and periadnexal lymphocytic infiltrates in the dermis, epidermal atrophy and edema, apoptotic keratinocytes and/or follicular obstruction 22 , and both can show granular IgM, IgG and C3 deposits at the dermoepidermal junction 22 .…”

Section: Histological Characteristicsmentioning

confidence: 99%

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Drug-induced lupus erythematosus

Gouveia,

Gonçalo

2023

PJDV

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Drug-induced lupus erythematosus is an autoimmune disease with unexpected onset after treatment with certain drugs. Clinically, this disease is very similar to idiopathic lupus erythematosus, although its manifestations are typically milder. In addition, the laboratory and histological changes of the induced forms are also not significantly different from the idiopathic condition, sometimes making the diagnosis of the drug-induced form a challenge for clinicians. This entity has been gaining relevance in the clinical setting and the number of drugs associated with it has been increasing, mainly due to the emergence of new biological therapies with a strong causal link with drug-induced lupus, such as tumor necrosis factor-alpha inhibitors. However, there are still no universally accepted diagnostic criteria to identify this disease, and information about its pathophysiology is still somewhat scarce, making it difficult to predict the most likely culprit drugs before there are enough reports to establish a strong link. In addition, although some risk factors have shown susceptibility for certain individuals, they are not yet fully understood. Given the possibility of disease reversal by the withdrawal of the offending drug, it is extremely important to be aware of the possible implication of a drug in the pathogenesis of this disease, and for clinicians who approach patients with lupus manifestations, particularly cutaneous manifestations, it is mandatory to look for the onset of new drugs used by the patient. This review will systematize the current knowledge about this drug-induced lupus, in terms of pathophysiology, clinical, histopathological, and laboratory manifestations, diagnosis, and treatment, as well as the most commonly implicated drugs.

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Section: Pathogenesis Of Di-clementioning

confidence: 99%

Section: Di-clementioning

confidence: 99%

Section: Histological Characteristicsmentioning

confidence: 99%

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Drug-induced lupus erythematosus

Gouveia,

Gonçalo

2023

PJDV

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Lupus Erythematosus and Antiphospholipid Syndrome

Dutz,

Khosravi‐Hafshejani

2024

Rook's Textbook of Dermatology

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Lupus erythematosus is an autoimmune disease that commonly affects the skin, and may present with cutaneous only disease. This chapter reviews the forms of cutaneous lupus‐specific skin disease (discoid lupus, subacute cutaneous lupus, lupus tumidus and acute cutaneous lupus), their clinical features, pathogenesis and treatment. A review of systemic lupus erythematosus is also provided with a discussion of diagnosis, clinical features, cutaneous aspects and treatment, germane for the dermatologist. Clinical features of neonatal lupus erythematosus and the antiphospholipid antibody syndrome, more commonly seen in systemic lupus erythematosus kindreds, are also discussed.

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