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López-Pardo Rico M, Buján Bonino C, Moreiras Arias N, Sáez Padilla J, Suárez Peñaranda JM, Sánchez-Aguilar Rojas MD, Rodríguez Granados MT. Photodistributed erythema multiforme in a polymedicated patient. J Dtsch Dermatol Ges 2023; 21:1557-1559. [PMID: 37840427 DOI: 10.1111/ddg.15215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/21/2023] [Indexed: 10/17/2023]
Affiliation(s)
- María López-Pardo Rico
- Department of Dermatology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Cecilia Buján Bonino
- Department of Dermatology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Noelia Moreiras Arias
- Department of Dermatology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - José Sáez Padilla
- Department of Dermatology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
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López-Pardo Rico M, Buján Bonino C, Moreiras Arias N, Sáez Padilla J, Suárez Peñaranda JM, Sánchez-Aguilar Rojas MD, Rodríguez Granados MT. Photodistributives Erythema multiforme bei einem Patienten mit Polypharmazie. J Dtsch Dermatol Ges 2023; 21:1557-1559. [PMID: 38082519 DOI: 10.1111/ddg.15215_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/21/2023] [Indexed: 12/18/2023]
Affiliation(s)
- María López-Pardo Rico
- Department of Dermatology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Cecilia Buján Bonino
- Department of Dermatology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Noelia Moreiras Arias
- Department of Dermatology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - José Sáez Padilla
- Department of Dermatology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
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McKinley BJ, Allen ME, Michels N. Photodistributed Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review and proposal for a new diagnostic classification. Eur J Med Res 2023; 28:188. [PMID: 37303053 DOI: 10.1186/s40001-023-01142-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 05/15/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Ultraviolet radiation (UVR) exposure is commonly reported as a risk factor for Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, minimal evaluation of photo-induced SJS/TEN has been conducted. Thus, this review identifies all cases of SJS/TEN that are linked to an acute exposure of UVR and outlines the unifying characteristics of these cases. Furthermore, the theoretical pathogenesis, differential diagnoses, and proposed diagnostic criteria are defined. METHODS PubMed, Google Scholar, and other databases and websites were searched from inception to September 2021 to identify studies that met inclusion criteria. The following keywords were utilized: "Stevens-Johnson syndrome" and "toxic epidermal necrolysis" with "ultraviolet," "photodistributed," "photo-induced," "photosensitivity," and "photo." One reviewer assessed study characteristics, with confirmation by a second. The risk of bias was assessed independently by another. RESULTS Thirteen patient cases were identified, all reporting ultraviolet radiation prior to rash onset and an underlying causal drug. Case classifications included 7/13 SJS and 6/13 TEN. All cases described the rash as photodistributed with UVR exposure prior to rash onset (delay of 1-3 days) and a causal drug. 10 cases provided evidence that the photodistributed rash lacked linear demarcation (as in a sunburn) with satellite target-like lesions. No cases described a flu-like prodrome. DISCUSSION Mucositis, palmar and plantar rash, a positive Nikolsky sign, and a prolonged disease course can help distinguish from photosensitive reactions, while a negative direct immunofluorescence test is important to distinguish from other photo-induced disorders. CONCLUSION Physicians should be aware that UVR may precipitate SJS/TEN in patients taking susceptible drugs. After a 24-h delay from UVR exposure, a non-distinct, photodistributed rash appears with no flu-like prodrome and progresses for at least 48 h to include vesiculobullous eruptions and mucous membrane involvement. Photodistributed SJS/TEN appears to be photo-drug-induced with a unique onset and rash presentation that should be recognized as a distinct diagnosis.
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Affiliation(s)
- Blake Jeffrey McKinley
- Department of Internal Medicine, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA.
| | - Mitchell Edger Allen
- Department of Primary Care, Rocky Vista University College of Osteopathic Medicine, Ivins, UT, 84738, USA
| | - Nicole Michels
- Department of Medical Humanities and Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine, 8401 S. Chambers Road, Parker, CO, 80134, USA.
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Buján Bonino C, Moreiras Arias N, López-Pardo Rico M, Sáez Padilla J, González Vilas D, Suárez Peñaranda JM, Rodríguez Granados MT. Vandetanib-mediated photoinduced erythema multiforme: A case report and photobiological study. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:276-278. [PMID: 35861042 DOI: 10.1111/phpp.12823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/08/2022] [Accepted: 07/15/2022] [Indexed: 05/10/2023]
Affiliation(s)
- Cecilia Buján Bonino
- Departament of Dermatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Noelia Moreiras Arias
- Departament of Dermatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - María López-Pardo Rico
- Departament of Dermatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Sáez Padilla
- Departament of Dermatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Daniel González Vilas
- Departament of Dermatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
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Patri A, Fabbrocini G, Megna M, Lauro W, D'Onofrio P, Gallo L. Itraconazole-induced photodistributed erythema multiforme. Dermatol Ther 2021; 34:e14901. [PMID: 33605022 DOI: 10.1111/dth.14901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/13/2020] [Accepted: 02/13/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Angela Patri
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Wanda Lauro
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Paola D'Onofrio
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Lucia Gallo
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
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Seegräber M, Pumnea T, Alharbi R, Flaig MJ, Herzinger T, Prinz J. Photoaggraviertes Erythema exsudativum multiforme (PEEM). Hautarzt 2018; 69:49-51. [DOI: 10.1007/s00105-018-4179-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Barboza-Guadagnini L, Bassas-Vila J, Aguilera J, Ferrándiz C, Carrascosa JM. Photoinduced target-like drug reaction to naproxen. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2016; 32:323-326. [PMID: 27552698 DOI: 10.1111/phpp.12268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/18/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Lorena Barboza-Guadagnini
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Julio Bassas-Vila
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - José Aguilera
- Photobiological Dermatology Laboratory, Medical Research Centre, Department of Dermatology and Medicine, Faculty of Medicine, University of Malaga, Malaga, Spain
| | - Carlos Ferrándiz
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - José-Manuel Carrascosa
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
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Goodale EC, White SD, Outerbridge CA, Everett AD, Affolter VK. A retrospective review of hyperaesthetic leucotrichia in horses in the USA. Vet Dermatol 2016; 27:294-e72. [PMID: 27374470 DOI: 10.1111/vde.12327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hyperaesthetic leucotrichia (HL) rarely affects horses and causes painful lesions on the dorsum that result in leucotrichia. This may be a variant of erythema multiforme (EM), but there are no studies investigating this condition. OBJECTIVES Describe the clinical and histological features of HL and compare them to the histological features of EM. METHODS A retrospective review of medical records from 1985 to 2015 identified 15 horses with HL. Thirteen biopsies of HL and five of EM were evaluated and compared. RESULTS Arabian horses and their crosses (χ(2) (1) = 8.56, P < 0.01) and American paint horses (χ(2) (1) = 6.64, P < 0.05) were over represented. The onset of clinical signs was between April and September (14 of 15). The most common clinical signs were pain (15 of 15), leucotrichia (11 of 15), crusting (10 of 15) and alopecia (8 of 15) limited to darkly pigmented skin. The lesions recurred seasonally in 6 of 12 horses and unpredictably in 1 of 12 horse. The most common histological features were the presence of large stellate cells (13 of 13) and oedema (12 of 13) in the superficial dermis, perivascular to diffuse lymphocytic inflammation (13 of 13), pigmentary incontinence (12 of 13), apoptotic keratinocytes (9 of 13) and vesicle formation (8 of 13). Horses with EM (n = 5) had significantly more acanthosis (z = -2.40, P < 0.02) and lymphocytic exocytosis (z = -3.1, P < 0.004), satellitosis (Fisher's exact P = 0.02) and inflammation (z = -2.91, P < 0.004). Horses with HL had significantly more pigmentary incontinence (z = 2.13, P < 0.04) and superficial dermal oedema (z = 2.56, P < 0.002). CONCLUSIONS HL affects primarily Arabian horses and American paint horses. It occurs mainly in summer and may recur. Histologically HL shares features with EM, but there are significant differences between them.
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Affiliation(s)
- Elizabeth C Goodale
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, 1 Garrod Drive, Davis, CA, 95616, USA
| | - Stephen D White
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, 1 Garrod Drive, Davis, CA, 95616, USA
| | - Catherine A Outerbridge
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, 1 Garrod Drive, Davis, CA, 95616, USA
| | - Angela D Everett
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, 1 Garrod Drive, Davis, CA, 95616, USA
| | - Verena K Affolter
- Department of Pathology, Microbiology & Immunology, School of Veterinary Medicine, University of California Davis, 1 Garrod Drive, Davis, CA, 95616, USA
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Photo-induced erythema multiforme associated with vandetanib administration. J Am Acad Dermatol 2014; 71:e142-4. [DOI: 10.1016/j.jaad.2014.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 04/29/2014] [Accepted: 05/01/2014] [Indexed: 11/24/2022]
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Scheinfeld NS, Chernoff K, Derek Ho MK, Liu YC. RETRACTED: Drug-induced photoallergic and phototoxic reactions – an update. Expert Opin Drug Saf 2014; 13:321-40. [DOI: 10.1517/14740338.2014.885948] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Noah S Scheinfeld
- New York Presbyterian Hospital, Weill Cornell Medical College, Department of Dermatology, New York, NY 10021, USA
| | - Karen Chernoff
- New York Presbyterian Hospital, Weill Cornell Medical College, Department of Dermatology, New York, NY 10021, USA
| | | | - Yen Chen Liu
- New York Presbyterian Hospital, Weill Cornell Medical College, Department of Dermatology, New York, NY 10021, USA
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