Amlodipine rash
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Amlodipine-Induced Rash: An Overview of Adverse Reactions
Introduction to Amlodipine and Rash
Amlodipine, a widely used antihypertensive medication, is known for its efficacy in managing high blood pressure. However, it has been associated with various dermatological adverse reactions, including different types of rashes. This article synthesizes findings from multiple studies to provide a comprehensive overview of amlodipine-induced rashes.
Petechial Rash
One documented case involved a patient who developed a brownish-black petechial rash on the lower limbs and feet after being stabilized on 10 mg of amlodipine daily. The rash was non-blanching and macular, and it resolved completely eight weeks after discontinuing amlodipine and switching to enalapril .
Linear IgA Disease
A rare case of amlodipine-induced linear IgA disease was reported in a 58-year-old woman. She developed pruritic, erythematous plaques with clear vesicles on her torso three weeks after starting amlodipine. Skin biopsy and immunofluorescence confirmed the diagnosis. The rash resolved promptly after discontinuing amlodipine and starting prednisolone and dapsone .
Fixed Drug Eruption
A 73-year-old male patient experienced a generalized fixed drug eruption that mimicked mycosis fungoides. The patient developed well-circumscribed, dusky erythematous macules and plaques on his trunk and legs. Histopathological examination confirmed the diagnosis, and the rash resolved two months after discontinuing amlodipine and starting topical clobetasol propionate .
Morbilliform Eruption
Another case involved a morbilliform eruption that clinically and histologically mimicked CD30+ mycosis fungoides. The rash resolved after discontinuing amlodipine, indicating a rare CD30+ pseudolymphoma cutaneous reaction to the drug .
Toxic Epidermal Necrolysis
A severe case of toxic epidermal necrolysis (TEN) was reported in a 71-year-old woman. She developed a pruritic maculopapular rash that progressed to involve 48.5% of her total body surface area, including conjunctival sloughing. The rash resolved after discontinuing amlodipine and receiving appropriate medical care .
Leukocytoclastic Vasculitis
A hypertensive elderly male developed leukocytoclastic vasculitis, presenting as a palpable purpuric rash on his legs, shoulders, buttocks, and back. The condition resolved completely after discontinuing amlodipine and administering short-term steroids .
Subacute Cutaneous Lupus Erythematosus
A 92-year-old woman developed subacute cutaneous lupus erythematosus (SCLE) localized to non-sun-exposed areas after starting amlodipine. The erythematous, papulosquamous rash resolved within four weeks of discontinuing the drug .
Perforating Lichenoid Reaction
A 54-year-old woman experienced a perforating lichenoid reaction characterized by intensely pruritic, hyperpigmented, keratotic papules. The rash resolved one month after discontinuing amlodipine and starting treatment with topical corticosteroids and triamcinolone acetonide .
Conclusion
Amlodipine, while effective for hypertension, can cause a variety of dermatological adverse reactions, ranging from mild rashes to severe conditions like toxic epidermal necrolysis. Clinicians should be aware of these potential side effects and consider discontinuing the drug if a rash develops. Prompt recognition and appropriate management are crucial for patient safety.
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