Gray Taylor, Segars Kelly, Farsi Maheera, Ross Risa, Miller Richard
Hospital Corporation of America/University of South Florida Morsani College of Medicine Graduate Medical Education: Department of Dermatology, Largo Medical Center Program, Largo, FL.
Dermatol Online J. 2019 Dec 15;25(12):13030/qt3xf8k540.
A 66-year-old man presented to the outpatient dermatology clinic with a chief complaint of a pruritic rash on his upper trunk and proximal upper extremities, which had been present for three weeks. Upon examination, he was found to have an erythematous, annular, and polycyclic eruption on the chest, upper back, and proximal extremities. A clinical diagnosis of subacute cutaneous lupus erythematosus (SCLE) was made. The patient was found to have a positive anti-nuclear antibody (ANA) in a speckled pattern and a positive anti-Ro antibody. A biopsy revealed an interface and lichenoid dermatitis with dermal mucin deposition, consistent with subacute cutaneous lupus erythematosus. The patient reported that he had recently been diagnosed with hypertension and began treatment with olmesartan, a potassium-sparing diuretic that blocks the angiotensin II receptor, commonly used as an antihypertensive or in patients with heart failure. Cutaneous reactions to olmesartan are rare and reported in <1% of patients in post-marketing surveillance. The patient discontinued use of olmesartan and the rash completely resolved within three weeks. To date, there are no other reported cases of drug induced SCLE in patients taking olmesartan to our knowledge.
一名66岁男性因上躯干和上肢近端瘙痒性皮疹为主诉，前来皮肤科门诊就诊，该皮疹已出现三周。检查发现，他的胸部、上背部和近端肢体有红斑性、环状和多环状皮疹。临床诊断为亚急性皮肤型红斑狼疮（SCLE）。患者抗核抗体（ANA）斑点型阳性，抗Ro抗体阳性。活检显示界面和苔藓样皮炎伴真皮粘蛋白沉积，符合亚急性皮肤型红斑狼疮。患者报告最近被诊断为高血压，并开始使用奥美沙坦治疗，奥美沙坦是一种保钾利尿剂，可阻断血管紧张素II受体，常用于治疗高血压或心力衰竭患者。奥美沙坦引起的皮肤反应罕见，上市后监测中报告的发生率<1%。患者停用奥美沙坦，皮疹在三周内完全消退。据我们所知，目前尚无其他服用奥美沙坦的患者发生药物性SCLE的报告病例。
