因多虑平致会阴部疼痛患者出现蔷薇糠疹样药疹。
Pityriasis rosea-like drug eruption due to nortriptyline in a patient with vulvodynia.
机构信息
Section of Dermatology, Department of Medicine, Pritzker School of Medicine, The University of Chicago, Chicago, IL 60637, USA.
出版信息
J Low Genit Tract Dis. 2013 Apr;17(2):226-9. doi: 10.1097/LGT.0b013e31825d7c5f.
BACKGROUND
Nortriptyline and other tricyclic antidepressants are widely used in the treatment of depression. They are also used in chronic pain syndromes such as vulvodynia. We report a case of pityriasis rosea (PR)-like eruption in a young woman who was treated with oral nortriptyline for vulvodynia.
CASE REPORT
The patient presented with photosensitivity and erythematous, well-defined, oval papules and patches, with fine collarettes of scale on the dorsal hands, upper arms, and trunk. She showed a complete resolution of her rash with discontinuation of nortriptyline, thereby supporting the diagnosis of a drug-induced reaction.
COMMENT
Pityriasis rosea-like drug eruptions have been associated with numerous medications, including angiotensin-converting enzyme inhibitors, antirheumatic drugs, lithium, and, more recently, biologics such as imatinib, adalimumab, and etanercept. A literature review did not reveal an association between PR-like drug eruptions and tricyclic antidepressants such as nortriptyline. We report a case of PR-like drug reaction to nortriptyline for clinical interest.
背景
去甲替林和其他三环类抗抑郁药被广泛用于治疗抑郁症。它们也用于慢性疼痛综合征，如外阴痛。我们报告了一例外阴痛患者口服去甲替林后出现玫瑰糠疹样疹。
病例报告
患者出现光敏性和红斑、界限清楚的椭圆形丘疹和斑块，伴有细鳞屑的领圈，在手背、上臂和躯干上。她停止使用去甲替林后皮疹完全消退，从而支持药物引起的反应的诊断。
评论
玫瑰糠疹样药物疹与许多药物有关，包括血管紧张素转换酶抑制剂、抗风湿药、锂，以及最近的生物制剂如伊马替尼、阿达木单抗和依那西普。文献复习未发现 PR 样药物疹与三环类抗抑郁药（如去甲替林）之间存在关联。我们报告了一例因去甲替林引起的 PR 样药物反应，以供临床参考。
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