PMID- 19762393
OWN - NLM
STAT- MEDLINE
DCOM- 20100105
LR  - 20131121
IS  - 1477-0962 (Electronic)
IS  - 0961-2033 (Linking)
VI  - 18
IP  - 11
DP  - 2009 Oct
TI  - Drug-induced lupus: an update on its dermatologic aspects.
PG  - 935-40
LID - 10.1177/0961203309106176 [doi]
AB  - Drug-induced lupus erythematosus (DILE) is defined as an entity characterized by 
      clinical manifestations and immunopathological serum findings similar to those of 
      idiopathic lupus but which is temporally related to continuous drug exposure and 
      resolves after discontinuation of the offending drug. Similar to idiopathic 
      lupus, DILE can be divided into systemic lupus erythematosus (SLE), subacute 
      cutaneous lupus erythematosus (SCLE) and chronic cutaneous lupus erythematosus 
      (CCLE). Based on the literature review and retrospective analysis of our case 
      series, we focused on the dermatological aspects of DILE. The cutaneous features 
      of drug-induced SLE are protean, including particularly purpura, erythema nodosum 
      and photosensitivity as well as the skin lesions characterizing both urticarial 
      and necrotizing vasculitis. The typical laboratory profile of systemic DILE 
      consists of positive antinuclear antibodies (ANA) and antihistone antibodies, the 
      latter being regarded as the serum marker of this subset. The drugs most 
      frequently implicated in the development of systemic DILE are hydralazine, 
      procainamide, isoniazid and minocycline. Drug-induced SCLE usually presents with 
      annular polycyclic or papulosquamous cutaneous manifestations as in the 
      idiopathic form, but blisters or targetoid lesions mimicking erythema multiforme 
      cannot rarely be associated. The clinical presentation is often generalized, with 
      involvement of the lower legs that are usually spared in idiopathic SCLE. ANA and 
      anti-Ro/SSA antibodies are usually present, whereas antihistone antibodies are 
      uncommonly found. Drugs associated with SCLE include particularly calcium channel 
      blockers, angiotensin-converting enzyme inhibitors, thiazide diuretics, 
      terbinafine and the recently reported tumour necrosis factor (TNF)-alpha 
      antagonists. Drug-induced CCLE is very rarely described in the literature and 
      usually refers to fluorouracile agents or TNF-alpha antagonists. The picture is 
      characterized by the occurrence of classic discoid lesions, but aspects of lupus 
      tumidus can occasionally develop. ANA are demonstrated in around two-thirds of 
      the cases. Management of DILE is based on the withdrawal of the offending drug. 
      Topical and/or systemic corticosteroids and other immunosuppressive agents should 
      be reserved for resistant cases.
FAU - Marzano, A V
AU  - Marzano AV
AD  - Department of Anesthesiology, Intensive Care and Dermatological Sciences, 
      University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli 
      e Regina Elena, Milan, Italy.
FAU - Vezzoli, P
AU  - Vezzoli P
FAU - Crosti, C
AU  - Crosti C
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Lupus
JT  - Lupus
JID - 9204265
RN  - 0 (Anti-Arrhythmia Agents)
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Antitubercular Agents)
RN  - 0 (Autoantibodies)
RN  - 26NAK24LS8 (Hydralazine)
RN  - FYY3R43WGO (Minocycline)
RN  - L39WTC366D (Procainamide)
RN  - V83O1VOZ8L (Isoniazid)
SB  - IM
MH  - Anti-Arrhythmia Agents/adverse effects
MH  - Anti-Bacterial Agents/adverse effects
MH  - Antihypertensive Agents/adverse effects
MH  - Antitubercular Agents/adverse effects
MH  - Autoantibodies/immunology
MH  - *Drug-Related Side Effects and Adverse Reactions
MH  - Humans
MH  - Hydralazine/adverse effects
MH  - Isoniazid/adverse effects
MH  - *Lupus Erythematosus, Cutaneous/chemically induced/immunology/pathology
MH  - *Lupus Erythematosus, Discoid/chemically induced/immunology/pathology
MH  - *Lupus Erythematosus, Systemic/chemically induced/immunology/pathology
MH  - Minocycline/adverse effects
MH  - Procainamide/adverse effects
MH  - Skin Diseases/chemically induced/immunology/pathology
RF  - 58
EDAT- 2009/09/19 06:00
MHDA- 2010/01/06 06:00
CRDT- 2009/09/19 06:00
PHST- 2009/09/19 06:00 [entrez]
PHST- 2009/09/19 06:00 [pubmed]
PHST- 2010/01/06 06:00 [medline]
AID - 18/11/935 [pii]
AID - 10.1177/0961203309106176 [doi]
PST - ppublish
SO  - Lupus. 2009 Oct;18(11):935-40. doi: 10.1177/0961203309106176.