Isoniazid-induced acne and pellagra. Occurrence in slow inactivators of isoniazid

Cohen, L. K.

doi:10.1001/archderm.109.3.377

Cited by 18 publications

(13 citation statements)

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“…Slow acetylators may be more susceptible to drug-induced pellagra. 114 Ishii sand Nishihara 92 reported eight patients with pellagra among 106 necropsy cases from isoniazid-treated tuberculosis. Other drug-induced cases of pellagra are explained by inhibition of the conversion of tryptophan to niacin; such drugs include 5-fluorouracil, pyrazinamide, 6-mercaptopurine, hydantoin, ethionamide, phenobarbital, azathioprine and chloramphenicol.…”

Section: Drug Inducedmentioning

confidence: 99%

Pellagra: a review with emphasis on photosensitivity

Wan

Moat

Anstey

2011

British Journal of Dermatology

148

147

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Niacin has recently been demonstrated to lower blood pressure in hypertensive patients and to reduce cardiovascular events when combined with a statin. As a consequence, niacin has been elevated from being of historical interest as the treatment for pellagra, to being a compound with possible relevance to contemporary therapeutics. In spite of this, niacin deficiency leading to pellagra continues to be a health problem in some countries. Characterized by an exposed-site hyperpigmented dermatitis, pellagra is generally accepted to have been the first photosensitivity syndrome described. At its worst, pellagra manifests as one of the most striking examples of systemic photosensitivity. This is the only photosensitivity syndrome where death is included as a cardinal clinical feature (the often quoted four 'Ds': dermatitis, diarrhoea, dementia and death). However, the pathogenetic mechanism for the photosensitivity caused by niacin deficiency has yet to be determined. This review seeks to update the classification and phenotypic characterization of the various forms of niacin-deficient photosensitivity. Previous speculation about possible mechanisms for the pathogenesis of photosensitivity due to niacin deficiency is reviewed in the context of advances in the understanding of the photochemical basis of photosensitivity reactions. The review concludes by highlighting research required to advance the understanding of this photosensitivity syndrome.

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Section: Drug Inducedmentioning

confidence: 99%

Pellagra: a review with emphasis on photosensitivity

Wan

Moat

Anstey

2011

British Journal of Dermatology

148

147

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“…[74] However, such a slow inactivation profile is most likely not the sole factor, as the incidence of isoniazidinduced acne remains low. [74] Acneiform eruption may occur late (up to 18 months) after initiation of isoniazid, and can improve with disruption of isoniazid. [74][75][76][77] …”

Section: Isoniazidmentioning

confidence: 99%

“…[74] Acneiform eruption may occur late (up to 18 months) after initiation of isoniazid, and can improve with disruption of isoniazid. [74][75][76][77] …”

Section: Isoniazidmentioning

confidence: 99%

Drug-Induced Acneiform Eruption

Du‐Thanh

Kluger

Bensalleh

et al. 2011

American Journal of Clinical Dermatology

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Drug-induced acne is a specific subset of acne that usually has some specific features, namely a monomorphic pattern, an unusual location of the lesions beyond the seborrheic areas, an unusual age of onset, a resistance to conventional acne therapy and, of course, the notion of a recent drug introduction. Many drugs can be responsible for such a clinical pattern. Corticosteroids, neuropsychotherapeutic drugs, antituberculosis drugs, and immunomodulating molecules are the more classical drugs associated with induced acne. Recently, new drugs, mainly targeted therapy in the field of oncology, such as epidermal growth factor receptor inhibitors, have been associated with an increased frequency of this adverse effect. Disruption of the culprit drug is rarely mandatory in cases of drug-induced acne. Close cooperation between the dermatologist and medical staff in charge of the patient is an important challenge to achieve optimal management of the initial disease.

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“…1), anabolic steroids including danazole [3] and testosterone (bodybuilding acne, doping acne), corticotropin [4], tetracyclines [5], vitamins B 1 , B 6 [6], B 12 [7], and D 2 , anticonvulsants [8], psychopharmacologic drugs, e.g. lithium carbonate [9] or amineptine [10], isoniazid [11], quinidine [12], azathioprine [13], cyclosporine A [14], etretinate [15], penicillamine, iodides and bromides (halogen acne) [16]. Some drugs such as testosterone and anabolic drugs may even induce acne fulminans [17].…”

Section: Drug-induced Acnementioning

confidence: 99%

Acneiform Dermatoses

Plewig

Jansen

1998

Dermatology

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Acneiform dermatoses are follicular eruptions. The initial lesion is inflammatory, usually a papule or pustule. Comedones are later secondary lesions, a sequel to encapsulation and healing of the primary abscess. The earliest histological event is spongiosis, followed by a break in the follicular epithelium. The spilled follicular contents provokes a nonspecific lymphocytic and neutrophilic infiltrate. Acneiform eruptions are almost always drug induced. Important clues are sudden onset within days, widespread involvement, unusual locations (forearm, buttocks), occurrence beyond acne age, monomorphous lesions, sometimes signs of systemic drug toxicity with fever and malaise, clearing of inflammatory lesions after the drug is stopped, sometimes leaving secondary comedones. Other cutaneous eruptions that may superficially resemble acne vulgaris but that are not thought to be related to it etiologically are due to infection (e.g. gramnegative folliculitis) or unknown causes (e.g. acne necrotica or acne aestivalis). oooooooooooooooooooo

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Isoniazid-induced acne and pellagra. Occurrence in slow inactivators of isoniazid

Cited by 18 publications

References 0 publications

Pellagra: a review with emphasis on photosensitivity

Pellagra: a review with emphasis on photosensitivity

Drug-Induced Acneiform Eruption

Acneiform Dermatoses

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