Hydroxychloroquine-induced acute generalized exanthematous pustulosis: a series of seven patients and review of the literature.


Journal

International journal of dermatology
ISSN: 1365-4632
Titre abrégé: Int J Dermatol
Pays: England
ID NLM: 0243704

Informations de publication

Date de publication:
Jun 2021
Historique:
revised: 07 12 2020
received: 25 08 2020
accepted: 29 12 2020
pubmed: 19 2 2021
medline: 22 6 2021
entrez: 18 2 2021
Statut: ppublish

Résumé

Hydroxychloroquine (HCQ)-induced acute generalized exanthematous pustulosis (AGEP) is poorly described in the literature. The aim of our study was to characterize the clinical, laboratory, allergological, and genetic features of HCQ-induced AGEP. We conducted a retrospective study of patients with HCQ-induced AGEP diagnosed between 2011 and 2019. We performed molecular analysis to identify variations in the IL36RN gene. We also reviewed similar cases reported between 1991 and March 2020. Seven female patients were included. The mean age was 47 years old, and the average time from HCQ start to onset of symptoms was 40 days. All patients received topical steroids with a full resolution of the rash within an average of 39 days after HCQ withdrawal. Patch tests were performed for three patients with positive results in one case. Genetic analyses were performed for three patients, and no mutation in the IL36RN gene was identified. The latent period and the duration for resolution of HCQ-induced AGEP may be longer than with other drugs due to the metabolic characteristics of HCQ. Mutations in the IL36RN gene were not identified in our patients.

Sections du résumé

BACKGROUND BACKGROUND
Hydroxychloroquine (HCQ)-induced acute generalized exanthematous pustulosis (AGEP) is poorly described in the literature. The aim of our study was to characterize the clinical, laboratory, allergological, and genetic features of HCQ-induced AGEP.
METHODS METHODS
We conducted a retrospective study of patients with HCQ-induced AGEP diagnosed between 2011 and 2019. We performed molecular analysis to identify variations in the IL36RN gene. We also reviewed similar cases reported between 1991 and March 2020.
RESULTS RESULTS
Seven female patients were included. The mean age was 47 years old, and the average time from HCQ start to onset of symptoms was 40 days. All patients received topical steroids with a full resolution of the rash within an average of 39 days after HCQ withdrawal. Patch tests were performed for three patients with positive results in one case. Genetic analyses were performed for three patients, and no mutation in the IL36RN gene was identified.
CONCLUSION CONCLUSIONS
The latent period and the duration for resolution of HCQ-induced AGEP may be longer than with other drugs due to the metabolic characteristics of HCQ. Mutations in the IL36RN gene were not identified in our patients.

Identifiants

pubmed: 33598928
doi: 10.1111/ijd.15419
doi:

Substances chimiques

IL36RN protein, human 0
Interleukins 0
Hydroxychloroquine 4QWG6N8QKH

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

742-748

Informations de copyright

© 2021 the International Society of Dermatology.

Références

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Auteurs

Rim Chaabouni (R)

Department of Dermatology, Hedi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.

Emna Bahloul (E)

Department of Dermatology, Hedi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.

Mariam Ennouri (M)

Molecular and Functional Genetics Laboratory, Department of Life Sciences, Faculty of Sciences of Sfax, University of Sfax, Sfax, Tunisia.

Rim Atheymen (R)

Laboratory of Pharmacology, Faculty of Medicine, University of Sfax, Sfax, Tunisia.

Khadija Sellami (K)

Department of Dermatology, Hedi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.

Slaheddine Marrakchi (S)

Department of Dermatology, Hedi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.

Slim Charfi (S)

Laboratory of Pathological Anatomy, Habib Bourguiba Hospital, Sfax, Tunisia.

Sonia Boudaya (S)

Department of Dermatology, Hedi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.

Meriem Amouri (M)

Department of Dermatology, Hedi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.

Noura Bougacha (N)

Molecular and Functional Genetics Laboratory, Department of Life Sciences, Faculty of Sciences of Sfax, University of Sfax, Sfax, Tunisia.

Hamida Turki (H)

Department of Dermatology, Hedi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.

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