Eczema-like drug eruption induced by clopidogrel
10.3760/cma.j.issn.1008-5734.2018.04.012
- VernacularTitle:氯吡格雷致湿疹样药疹
- Author:
Fangming ZHANG
1
;
Cheng XIE
Author Information
1. 215006 苏州大学附属第一医院药学部;215153 苏州科技城医院/南京医科大学附属苏州医院药学部
- Publication Type:Journal Article
- Keywords:
Platelet aggregation inhibitors;
Anaphylaxis;
Eczema
- From:
Adverse Drug Reactions Journal
2018;20(4):302-304
- CountryChina
- Language:Chinese
-
Abstract:
A 69-year-old male patient received oral aspirin (100 mg once daily),ticagrelor (45 mg twice daily),amlodipine besylate (5 mg once daily),losartan potassium (50 mg once daily),metoprolol sustained release tablets (47. 5 mg once daily ),and atorvastatin (10 mg once daily )after coronary angiography. After 28 days of treatments,ticagrelor was discontinued for economic reason and changed to clopidogrel (75 mg once daily). The next day,symmetrical erythema and needle-shaped papules appeared on skin of the abdomen and limbs,and gradually throughout the whole body. Then,mung bean-sized blisters and papulo-vesicle appeared and part of them fused into lamella with a small amount of exudation and severe itching. Two weeks later,the skin of the distal extremities thickened and the skin surface was rough and desquamated. The patient had developed 2 episodes of similar symptoms in the past. Six years ago,the similar symptoms occurred for the first time. The patient developed rashes 4 to 5 days after taking aspirin and clopidogrel after PCI. Clopidogrel was discontinued after 10 months and,half a month later,the skin symptoms completely subsided. Fourteen months ago,the similar skin symptoms occurred for the second time. Clopidogrel was given after PCI and rashes appeared 2 days later. The skin rash was relieved after anti-allergic treatments. The patient stopped taking clopidogrel herself 9 months later,the skin symptoms completely subsided half a month later. Clopidogrel-induced eczema-like drug eruption was considered. Clopidogrel was withdrawn and antihistamine,glucocorticoid,and antipruritic were given. Two weeks after drug withdrawal,the papules on the trunk were flattened and became dry,the part of the ruptured vesicles on the abdomen healed,scales of the limbs reduced,itching subsided,and no new skin lesions appeared.
