By Esen Özkaya, Kurtuluş Didem Yazganoğlu
Adverse cutaneous drug reactions (ACDR) are one of the so much common occasions in sufferers receiving drug treatment. Cardiovascular (CV) medicinal drugs are a tremendous crew of substances with power hazard of constructing ACDR specially in aged as advertising of extra new medicines and their prescription proceed to extend. besides the fact that, like with so much different medications the precise prevalence of cutaneous negative effects from CV medications is tough to estimate as a result of sporadic reporting. in addition, a competent designation of a definite drug because the explanation for a definite kind of response can not often be made. except the well known angioedema/urticaria from ACE inhibitors, lichen planus / lichenoid response from beta adrenergic blockers and photosensitivity from thiazid diuretics, ACDR from CV medicines should be obvious in a large spectrum extending to infrequent yet life-threatening stipulations similar to erythroderma, Stevens-Johnson syndrome, poisonous epidermal necrolysis or drug hypersensitive reaction syndrome. during this complete evaluation, the stated different types of ACDR to CV medicines should be mentioned based on drug category and the kind of dermatologic response with designated emphasize on cross-reactions and the position of patch trying out in diagnosis.
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Extra info for Adverse Cutaneous Drug Reactions to Cardiovascular Drugs
Xerosis is a common side effect of lipid-lowering drugs. Peripheral edema is frequently associated with the use of adrenergic neuron blockers (reserpine), CCBs, and vasodilators. Some drugs may cause ulceration of the skin and mucosa. There are increasing reports on perianal, peristomal, oral, or skin ulcerations with nicorandil, a vasodilatory drug used to treat angina . 44 1 General Aspects of Adverse Cutaneous Drug Reactions Fig. 66 Indurated, reddish, confluent papules on the extensor surface of the forearm in a patient with interstitial granulomatous drug reaction from thalidomide Fig.
57). It is a condition with a significant risk of morbidity and mortality. , maculopapular, lichenoid, eczematous, may evolve into erythroderma during their course. It usually begins within a few weeks following treatment with the causative drug. , mycosis fungoides. Pruritus, high fever, and enlargement of the lymph nodes may accompany. The skin thermoregulation and the fluid/electrolyte balance are usually impaired. Hypoalbuminemia may occur. There is a tendency towards secondary infection. Sulfonamides, allopurinol, barbiturates, hydantoin derivatives, phenylbutazone, carbamazepine, NSAIDs, gold salts, and lithium are among the common inducers Characteristic Features of Adverse Cutaneous Drug Reactions Fig.
Histopathology of bullous lesions shows full-thickness epidermal necrosis with subepidermal blistering. At least one mucosal area is involved such as oral, genital, conjunctival, pharyngeal, laryngeal, or perianal, showing painful hemorrhagic bullae and erosions. The lips are typically covered with hemorrhagic crusts (Fig. 59). Oral candidiasis may develop as a consequence of disturbed oral hygiene. Bronchitis, pneumonia, pericarditis, glomerulonephritis, and hepatitis may develop. The mortality rate is approximately 5–10 % in SJS [49, 50].