lichenoid drug eruption treatment coumadin

Lichenoid eruptions are uncommon skin rashes that can be induced by many environmental agents, medications or industrial by-products such as inhaled particles. The rash of a lichenoid drug eruption can sometimes be difficult to distinguish from idiopathic lichen planus because of similarities in the clinical appearance and the pathology seen on skin biopsy. Albalbissi and colleagues described a case of cutaneous drug reaction to apixaban in 78-year-old female that appeared 9 days after taking the drug that manifested mainly as a pruritic rash starting on the right upper arm and then progressing to her face 2 days later. the site you are agreeing to our use of cookies.

You can be signed in via any or all of the methods shown below at the same time.The email address and/or password entered does not match our records, please check and try again. However, it failed to identify cross reactivity to apixaban, indicating that a delayed reading of test at more than 5 days may be indicated.Etanercept has been associated with drug-induced lichen planus.The United States Food and Drug Administration (FDA) adverse drug reporting system public dashboard (accessed 14 January 2020) reported 4528 cases of skin and subcutaneous tissue disorder since 2008, classified as rash, pruritus, urticaria, face swelling, angioedema, drug eruption, and other hypersensitivity reactions, with most of those cases reported in the age group of 65–85 years of age.

DermNet NZ does not provide an online consultation service. Cutan Ocul Toxicol . The patient in this case underwent patch testing prior to switching to apixaban and was found to test positive at 5 days to dabigatran and edoxaban. DermNet provides Google Translate, a free machine translation service. We believe that our case report highlights a rare ADR associated with the apixaban and can help extend pharmacovigilance by further raising clinicians’ awareness of atypical ADR patterns, avoiding delays in their diagnosis and treatment. It is important for physicians to recognize that immunologically mediated delayed hypersensitivity reactions, although rare in occurrence, can have significant impact on patient’s quality of life.

The exact pharmacologic mechanism by which apixaban causes this type of ADR is unclear; however, as DOACs become increasingly utilized and favored over warfarin because of their superior safety and convenience, post-marketing observations describing such drug hypersensitivity reactions are critical. This case further includes biopsy to prove the type of hypersensitivity reaction as well as re-challenge to apixaban, further strengthening the causal relationship with the drug.

https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( Sign in here to access free tools such as favourites and alerts, or to access personal subscriptionsIf you have access to journal content via a university, library or employer, sign in hereResearch off-campus without worrying about access issues. Physical examination at a follow up visit revealed that steroid ointment had cleared some of the rash, but did not completely resolve, and the patient reported no itching. The patient denies any changes in clothing, detergents, or contact with chemicals.

Manuscript content on this site is licensed under Creative Commons Licenses Lean Library can solve it Simply select your manager software from the list below and click on download. In medicine, a drug eruption is an adverse drug reaction of the skin. If you have any concerns with your skin or its treatment, see a dermatologist for advice. Most drug-induced cutaneous reactions are mild and disappear when the offending drug is withdrawn.

Simply select your manager software from the list below and click on download. At this time, the patient was diagnosed to most likely have drug-induced lichen planus with the possibility of apixaban being the culprit agent, and was offered biopsy for further evaluation. [Medline] .

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