Piérard Franchimont C, Henry F, Piérard G E
Service de Dermatopathologie, CHU du Sart Tilman, Liège, Belgique.
Ann Dermatol Venereol. 2001 Oct;128(10 Pt 1):1040-2.
We report a case of severe pustular vasculitis most probably due to losartan (Cozaar) which is an antihypertensive drug inhibiting the receptors for angiotensin II.
A 64-year-old woman, suffering from hypertension, developed a widespread and rapidly evolving bullous and pustular eruption without any other clinical sign. Leucocytoclastic vasculitis and junctional blisters were present with deposits of both IgA and IgG at these sites. Withdrawal of losartan, which was the only drug taken by the patient, and tapered corticotherapy cleared the lesions. The rash left a prominent mottled hyperpigmentation. It did not recur during the following months despite the presence of antineutrophil cytoplasmic antibodies.
So far only a few cutaneous side effects have been reported following losartan intake. This drug was the likely culprit in the present case. Vasculitis was extremely severe and polymorphous.
我们报告一例严重的脓疱性血管炎病例，极有可能是由氯沙坦（科素亚）引起的，氯沙坦是一种抑制血管紧张素II受体的降压药物。
一名64岁患有高血压的女性出现了广泛且迅速发展的大疱性和脓疱性皮疹，无任何其他临床症状。存在白细胞破碎性血管炎和交界性水疱，这些部位有IgA和IgG沉积。停用患者唯一服用的氯沙坦，并逐渐减少皮质激素治疗后，皮损消退。皮疹留下了明显的斑驳状色素沉着。尽管存在抗中性粒细胞胞浆抗体，但在接下来的几个月里皮疹未复发。
到目前为止，服用氯沙坦后仅报告了少数皮肤副作用。在本病例中，该药物可能是罪魁祸首。血管炎极其严重且多样。
