Ixekizumab for treatment of refractory acute generalized exanthematous pustulosis caused by hydroxychloroquine

Munshi, Mohammad; Junge, Alexandra; Gadaldi, Karolina; Yawalkar, Nikhil; Heidemeyer, Kristine

doi:10.1016/j.jdcr.2020.05.014

Cited by 9 publications

(7 citation statements)

References 11 publications

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“…At the moment, HCQ maintains its popularity and tens of thousands of people across the world are still receiving the current drug 1 . After the COVID‐19 pandemic, several cutaneous side effects of HCQ are reported 2‐7 . Herein, we reported generalized exanthema after a single dose of using HCQ.…”

Section: No/type Of Drug Reaction Age/gender Hcq Treatment Doses Indimentioning

confidence: 81%

“…These side effects can be listed as acute generalized exanthematous pustulosis, urticaria, palmoplantar itching, erythema multiforme, drug reaction with eosinophilia and systemic symptoms, and exacerbation of psoriasis (Table 1). 2‐7 …”

Section: No/type Of Drug Reaction Age/gender Hcq Treatment Doses Indimentioning

confidence: 99%

“…In this context, acute generalized exanthematous pustulosis as in cases 7 and 9 approximately appeared at the same time which may suggest that case 9 was more compatible with a drug reaction rather than a manifestation of COVID‐19 (Table 1). 5,7 The group of “HCQ use for diseases unrelated to the COVID‐19” may show that cutaneous reactions such as AGEP, DRESS, and erythema multiforme may appear with long term HCQ use. Moreover, “HCQ use for COVID‐19 prophylaxis” group shows that even low and single doses of HCQ may lead to cutaneous side effects such as urticaria and pruritus.…”

Section: No/type Of Drug Reaction Age/gender Hcq Treatment Doses Indimentioning

confidence: 99%

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Generalized exanthema due to hydroxychloroquine during COVID‐19 prophylaxis

et al. 2021

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is a drug that is used for both chemoprophylaxis and treatment of COVID-19. At the moment, HCQ maintains its popularity and tens of thousands of people across the world are still receiving the current drug. 1 After the COVID-19 pandemic, several cutaneous side effects of HCQ are reported. 2-7 Herein, we reported generalized exanthema after a single dose of using HCQ. A 58-year-old male patient presented with resistant rashes on his upper extremities and neck region. Rashes appeared all over the body along with severe pruritus just a day after receiving a single 200 mg dose of oral hydroxychloroquine for COVID-19 prophylaxis. The patient had started hydroxychloroquine without any recommendation. He was also receiving pramipexole for restless legs syndrome for 3 years. He presented to our dermatology outpatient

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Section: No/type Of Drug Reaction Age/gender Hcq Treatment Doses Indimentioning

confidence: 81%

Section: No/type Of Drug Reaction Age/gender Hcq Treatment Doses Indimentioning

confidence: 99%

Section: No/type Of Drug Reaction Age/gender Hcq Treatment Doses Indimentioning

confidence: 99%

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Generalized exanthema due to hydroxychloroquine during COVID‐19 prophylaxis

et al. 2021

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“…Anti -IL-5 or IL-5 receptor monoclonal antibodies such as mepolizumab, benralizumab and reslizumab have been successfully used to treat DRESS syndrome patients in a number of case reports, including cases which responded suboptimally to systemic corticosteroids [ 79 , 113 ]. There have also been case reports of successful treatment of refractory and severe AGEP using anti -IL-17 monoclonal antibodies such as secukinumab and ixekizumab [ [114] , [115] , [116] ]. On top of benefiting the corticosteroid-refractory patients, the use of cytokine-specific biologics may also achieve steroid-sparing effect, thus reducing the side effects from corticosteroids [ 113 ].…”

Section: Introductionmentioning

confidence: 99%

Helper T cell subsets: Development, function and clinical role in hypersensitivity reactions in the modern perspective

Kan,

Tang,

2024

Heliyon

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“…9 Several numbers of life-threatening mucocutaneous reactions are [10][11][12][13][14][15][16] The mortality rate is varied from less than 5% to higher than 14.8%. 17,18 Severe skin reactions are potentially life-threatening, and delayed diagnosis is associated with high mortality rates and internal organ damage which has permanent sequelae in patients. Earlier diagnosis is even more important for proper medical management of COVID-19 patients with severe mucocutaneous reactions; since these patients especially hospitalised ones are usually in a complicated situation (because of multi-organ failures), management of any potential life-threatening reactions is more challenging.…”

mentioning

confidence: 99%

Severe and life‐threatening COVID‐19‐related mucocutaneous eruptions: A systematic review

Mashayekhi

Seirafianpour

Mohammad

et al. 2021

Int J Clinical Practice

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Objectives Earlier diagnosis and the best management of virus‐related, drug‐related or mixed severe potentially life‐threatening mucocutaneous reactions of COVID‐19 patients are of great concern. These patients, especially hospitalised cases, are usually in a complicated situation (because of multi‐organ failures), which makes their management more challenging. In such consultant cases, achieving by the definite beneficial management strategies that therapeutically address all concurrent comorbidities are really hard to reach or even frequently impossible. Methods According to the lack of any relevant systematic review, we thoroughly searched the databases until 5 October 2020 and finally found 57 articles including 93 patients. It is needed to know clinical presentations of these severe skin eruptions, signs and symptoms of COVID in these patients, time of skin rash appearance, classifying drug‐related or virus‐related skin lesions, classifying the type of skin rash, patients’ outcome and concurrent both COVID‐19 therapy and skin rash treatment. Result Severe and potential life‐threatening mucocutaneous dermatologic manifestations of COVID‐19 usually may be divided into three major categories: virus‐associated, drug‐associated, and those with uncertainty about the exact origin. Angioedema, vascular lesions, toxic shock syndrome, erythroderma, DRESS, haemorrhagic bulla, AGEP, EM, SJS and TEN, generalised pustular figurate erythema were the main entities found as severe dermatologic reactions in all categories. Conclusion We can conclude vascular injuries may be the most common cause of severe dermatologic manifestations of COVID‐19, which is concordant with many proposed hypercoagulation tendencies and systemic inflammatory response syndrome as one of the most important pathomechanisms of COVID‐19 so the skin may show these features in various presentations and degrees.

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Ixekizumab for treatment of refractory acute generalized exanthematous pustulosis caused by hydroxychloroquine

Cited by 9 publications

References 11 publications

Generalized exanthema due to hydroxychloroquine during COVID‐19 prophylaxis

Generalized exanthema due to hydroxychloroquine during COVID‐19 prophylaxis

Helper T cell subsets: Development, function and clinical role in hypersensitivity reactions in the modern perspective

Severe and life‐threatening COVID‐19‐related mucocutaneous eruptions: A systematic review

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