Department of Dermatology, Hedi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.
Molecular and Functional Genetics Laboratory, Department of Life Sciences, Faculty of Sciences of Sfax, University of Sfax, Sfax, Tunisia.
Int J Dermatol. 2021 Jun;60(6):742-748. doi: 10.1111/ijd.15419. Epub 2021 Feb 17.
Hydroxychloroquine (HCQ)-induced acute generalized exanthematous pustulosis (AGEP) is poorly described in the literature. The aim of our study was to characterize the clinical, laboratory, allergological, and genetic features of HCQ-induced AGEP.
We conducted a retrospective study of patients with HCQ-induced AGEP diagnosed between 2011 and 2019. We performed molecular analysis to identify variations in the IL36RN gene. We also reviewed similar cases reported between 1991 and March 2020.
Seven female patients were included. The mean age was 47 years old, and the average time from HCQ start to onset of symptoms was 40 days. All patients received topical steroids with a full resolution of the rash within an average of 39 days after HCQ withdrawal. Patch tests were performed for three patients with positive results in one case. Genetic analyses were performed for three patients, and no mutation in the IL36RN gene was identified.
The latent period and the duration for resolution of HCQ-induced AGEP may be longer than with other drugs due to the metabolic characteristics of HCQ. Mutations in the IL36RN gene were not identified in our patients.
羟氯喹（HCQ）诱导的急性泛发性发疹性脓疱病（AGEP）在文献中描述甚少。本研究旨在描述 HCQ 诱导的 AGEP 的临床、实验室、过敏和遗传特征。
我们对 2011 年至 2019 年间诊断为 HCQ 诱导的 AGEP 的患者进行了回顾性研究。我们进行了分子分析，以确定 IL36RN 基因的变异情况。我们还回顾了 1991 年至 2020 年 3 月间报告的类似病例。
共纳入 7 例女性患者，平均年龄为 47 岁，从开始使用 HCQ 到出现症状的平均时间为 40 天。所有患者均接受了局部皮质类固醇治疗，在 HCQ 停药后平均 39 天内皮疹完全消退。对 3 例患者进行了斑贴试验，其中 1 例阳性。对 3 例患者进行了基因分析，未发现 IL36RN 基因突变。
由于 HCQ 的代谢特点，HCQ 诱导的 AGEP 的潜伏期和消退时间可能比其他药物更长。我们的患者中未发现 IL36RN 基因突变。
