Stevens-Johnson syndrome in association with hydroxychloroquine treatment for rheumatoid arthritis

Leckie, Maggie J.

doi:10.1093/rheumatology/41.4.473

Cited by 30 publications

(18 citation statements)

References 5 publications

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“…Chloroquine and hydroxychloroquine have been implicated in severe cutaneous adverse reactions, including Stevens-Johnson syndrome, 44 toxic epidermal necrolysis, 45,46 DRESS (drug reaction with eosinophilia and systemic symptoms) 47,48 and others. Although rare, these entities should be considered in patients with new-onset fever, exanthem or mucositis in the weeks after the start of treatment, particularly when accompanied by new hematologic abnormalities (such as lymphopenia, eosinophilia or atypical lymphocytosis) or unexplained liver or kidney injury.…”

Section: Immunologically Mediated Adverse Reactionsmentioning

confidence: 99%

Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection

Juurlink

2020

CMAJ

202

191

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Section: Immunologically Mediated Adverse Reactionsmentioning

confidence: 99%

Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection

Juurlink

2020

CMAJ

202

191

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“…- There were 4 cases of Stevens-Johnson syndrome/toxic epidermal necrolysis (TEN) reported with HCQ, 1 photo-induced and another with AGEP/TEN overlap [15,16,17,18] and 1 case was reported with Qud [19]. …”

Section: Discussionmentioning

confidence: 99%

Cutaneous Adverse Drug Reactions with Antimalarials and Allergological Skin Tests

et al. 2015

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Background: Currently used antimalarial drugs (AM) are hydroxychloroquine and chloroquine, which are prescribed for many autoimmune disorders. The value of skin tests on cutaneous adverse drug reactions (CADR) with AM remains unknown. Objective: The main objective of this retrospective study is to know whether skin tests for AM are useful and how to manage the recovery of AM therapy in these patients. Methods: All patients referred for suspected CADR secondary to AM between 2001 and 2014 in eight French dermatology centers were retrospectively reviewed. Results: We report herein a retrospective series of 20 patients with CADR and AM involvement. Skin tests, performed in 14/20 patients, were negative in all cases. Six patients had an oral provocation test with recurrence of CADR in 1 case. Conclusion: We encourage dermatologists to perform oral provocation tests in nonsevere CADR in order to allow AM rechallenge at progressive doses.

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“…There are reports of hydroxychloroquineinduced TEN, 15,16 which was a concern in cases 1 and 2 leading to its initial discontinuation, although both patients have had subsequent reintroduction of hydroxychloroquine without incident. Differentiating druginduced TEN/SJS in patients with LE from TEN-like cutaneous LE may be difficult, and it is possible that some previously reported cases may have been misclassified.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Toxic Epidermal Necrolysis-Like Cutaneous Lupus in Pediatric Patients: A Case Series and Review

Brandling‐Bennett

et al. 2016

Pediatrics

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Bullous eruptions in patients with underlying systemic lupus erythematosus (LE) can mimic toxic-epidermal necrolysis (TEN), a rapidly progressive mucocutaneous reaction usually associated with medication use. Differentiating between classic drug-induced TEN and TEN-like cutaneous LE is important but difficult. We report a series of 3 patients with pediatric systemic LE who were admitted with severe worsening of skin disease resembling TEN. However, the initial photo-distribution of the eruption, subacute progression, limited mucosal involvement, mild systemic symptoms, supportive biopsy and laboratory results, and lack of culprit drugs was more suggestive of a TEN-like cutaneous LE. These patients recovered with various systemic immunosuppressive medications including methylprednisolone, intravenous immunoglobulin, and plasmapheresis. Our cases are rare and demonstrate key clinical and histologic features of TEN-like cutaneous LE in young patients and the importance of differentiating this entity from drug-induced TEN.

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Stevens-Johnson syndrome in association with hydroxychloroquine treatment for rheumatoid arthritis

Cited by 30 publications

References 5 publications

Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection

Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection

Cutaneous Adverse Drug Reactions with Antimalarials and Allergological Skin Tests

Toxic Epidermal Necrolysis-Like Cutaneous Lupus in Pediatric Patients: A Case Series and Review

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