A unique case of idiosyncratic drug induced psoriasis

Open Science Journal

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Title A unique case of idiosyncratic drug induced psoriasis
Creator Aquilina, Neville
Bellia, Edward
Subject dermatology, medicine, geriatrics
Idiosyncratic, Psoriasiform eruption, Psoriasis, Diabetes, Elderly, Gliclazide
Description This case report intends to portray a lesser known dermatological adverse reaction to the sulphonylurea drug gliclazide, which is in fact poorly identified in the literature. Psoriasis secondary to gliclazide has been confirmed by skin biopsy in a patient who never reported a history of similar psoriasiform rashes, with onset two days following introduction of the drug, whilst it subsided rather quickly following withdrawal of the drug. This constitutes sufficient evidence in itself to confirm this diagnosis in a patient who was never exposed to the drug previously and does not require a re-challenge with gliclazide. Histology of drug induced psoriasis is identical to the idiopathic psoriasis vulgaris form, with the presence of scarce eosinophils in the dermis, apart from the usual neutrophils and predominantly lymphocytic infiltrates, however the eosinophil count in the peripheral blood typically fails to become elevated, as was the case in our patient. Despite being a de novo event, there are predisposing factors which may lower the threshold for emergence of psoriasis in an individual, primarily a genetic predisposition (or positive family history) but also stress, infection (particularly with β-haemolytic streptococci), immune modulating diseases such as HIV (human immunodeficiency virus) and other drugs that are more notoriously ‘psoriasiform inducing’ (such as β-blockers, lithium, anti-malarial agents, tetracyclines and tumour necrosis factor inhibitors), whilst there is also a loose association with exfoliative dermatitis.
Publisher Open Science Journal
Date 2018-06-05
Type info:eu-repo/semantics/article

Format application/pdf
Identifier https://osjournal.org/ojs/index.php/OSJ/article/view/1488
Source Open Science Journal; Vol 3, No 2 (2018): Open Science Journal
Language eng
Relation https://osjournal.org/ojs/index.php/OSJ/article/view/1488/172
Rights Copyright (c) 2018 Open Science Journal

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