Photodistributed telangiectasia following the use of psychotropic drugs

Abstract

Photodistributed telangiectasia is a poorly known and rarely reported dermatological side effect of many drugs. Psychotropic drugs were also reported to cause eruptive telangiectasias more frequently than other classes of drugs. Here, we report, for the first time to the best of our knowledge, two cases of photodistributed telangiectasias in patients treated with mirtazapine and levetiracetam.

Photodistributed eruptive telangiectasias: an uncommon adverse drug reaction. A retrospective case series

“…2 Cases of PT have been described with calcium channel blockers (CCBs) such as nifedipine, amlodipine and felodipine, [3][4][5][6][7] cephalosporins such as cefotaxime, 8 selective serotonin reuptake inhibitors (SSRIs), such as escitalopram and venlafaxine 2,9 and psychotropic drugs such as mirtazapine and levetiracetam. 10 The pathological mechanisms of drug-induced PT are unclear, although photoexposure is considered to be a causative or aggravating trigger. Following administration of photosensitive drugs and subsequent photoexposure, UVA, UVB and visible radiation may be absorbed by the pharmacological molecule or its metabolite(s), which act like chromophores.…”

“…5 Psychotropic drugs have been also reported to cause eruptive telangiectasias more frequently than other classes of drugs. 10 This could be related to the release of serotonin around the nerve endings in the skin, regulating inflammation and release of cytokines from keratinocytes and lymphocytes. 13 Iatrogenic PT usually affects both men and women between the third and the eighth decade of life.…”

“…Reports of iatrogenic telangiectasia are scarce, and only some of these cases were related to photoexposure 2 . Cases of PT have been described with calcium channel blockers (CCBs) such as nifedipine, amlodipine and felodipine, 3–7 cephalosporins such as cefotaxime, 8 selective serotonin reuptake inhibitors (SSRIs), such as escitalopram and venlafaxine 2, 9 and psychotropic drugs such as mirtazapine and levetiracetam 10 …”

“…However, vasodilatation is also a secondary effect of CCB, and it is possible that telangiectasias could result from a toxic effect of the drugs themselves 5 . Psychotropic drugs have been also reported to cause eruptive telangiectasias more frequently than other classes of drugs 10 . This could be related to the release of serotonin around the nerve endings in the skin, regulating inflammation and release of cytokines from keratinocytes and lymphocytes 13 …”