Desai Nina, Alexis Andrew F, DeLeo Vincent A
Department of Dermatology, St. Luke's-Roosevelt Hospital Center, New York, New York 10025, USA.
Cutis. 2010 Aug;86(2):82-4.
Diltiazem hydrochloride, a member of the calcium channel blocker family of antihypertensive medications, has been found to produce many cutaneous reactions, such as photodistributed hyperpigmentation. We report a 53-year-old black woman who presented with facial darkening that began 6 months after starting diltiazem. Areas were not responsive to topical bleaching creams. Biopsy showed postinflammatory pigment alteration with a largely burned-out lichenoid dermatitis. The results of all laboratory evaluations were negative, including complete blood cell count, antinuclear antibodies, anti-Ro antibodies, and anti-La antibodies. Patch testing and photo-patch testing to numerous drugs including diltiazem were negative. Phototesting revealed a normal minimal erythema dose to UVA but a slightly reduced minimal erythema dose to UVB. Diltiazem was then stopped and hydralazine hydrochloride was started. While UVA has been thought to be the main culprit in drug-induced photosensitive reactions, this case demonstrates that UVB may possibly play a role in diltiazem-induced photodistributed hyperpigmentation.
盐酸地尔硫䓬是抗高血压药物中钙通道阻滞剂家族的一员，已发现它会引发多种皮肤反应，如光分布性色素沉着。我们报告了一名53岁的黑人女性，她在开始服用地尔硫䓬6个月后出现面部变黑。局部使用美白霜对此无效。活检显示炎症后色素改变，伴有基本消退的苔藓样皮炎。所有实验室检查结果均为阴性，包括全血细胞计数、抗核抗体、抗Ro抗体和抗La抗体。对包括地尔硫䓬在内的多种药物进行的斑贴试验和光斑贴试验均为阴性。光试验显示对UVA的最小红斑量正常，但对UVB的最小红斑量略有降低。随后停用了地尔硫䓬并开始使用盐酸肼屈嗪。虽然UVA一直被认为是药物性光敏反应的主要元凶，但该病例表明UVB可能在地尔硫䓬引起的光分布性色素沉着中起作用。
