Can metformin cause a rash
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Can Metformin Cause a Rash?
Metformin, a widely used medication for managing type 2 diabetes, has been associated with various adverse drug reactions (ADRs), including skin rashes. This article synthesizes findings from multiple case reports to explore the potential of metformin to cause skin rashes.
Rosacea-like Facial Rash
Metformin and Facial Skin Rash
A case study reported a 29-year-old woman who developed a facial skin rash during metformin treatment. Clinical evaluations ruled out systemic diseases, and the rash improved upon discontinuation of metformin. The reappearance of the rash upon reintroduction of the drug suggested a probable association between metformin and the skin rash, as indicated by the Naranjo probability scale.
Leukocytoclastic Vasculitis (LV)
Metformin-Induced Vasculitis
Another case involved a 33-year-old woman who developed palpable purpura on her lower limbs after starting metformin. The rash improved significantly after stopping the medication, and a skin biopsy confirmed leukocytoclastic vasculitis (LV). The recurrence of the rash upon re-administration of metformin further supported the drug's role in inducing LV.
DRESS Syndrome
Drug Rash with Eosinophilia and Systemic Symptoms
A rare but severe reaction known as DRESS syndrome was reported in a 40-year-old man following metformin administration. The patient exhibited a rash, generalized pruritus, lymphadenopathy, and eosinophilia. The symptoms improved significantly after discontinuing metformin, highlighting the importance of recognizing this potential ADR for prompt diagnosis and treatment.
Acute Pancreatitis and Skin Manifestations
Rash Associated with Pancreatitis
Although primarily presenting with abdominal pain, acute pancreatitis can also manifest as a skin rash. A case report linked metformin to acute pancreatitis in a young, healthy man, suggesting that skin rashes could be a secondary manifestation of this condition.
Conclusion
The evidence from multiple case reports indicates that metformin can indeed cause various types of skin rashes, including rosacea-like facial rash, leukocytoclastic vasculitis, and DRESS syndrome. Clinicians should be aware of these potential ADRs to ensure prompt diagnosis and appropriate management.
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