Mizuta Takahiro, Kato Miyuki
Department of Dermatology, Tokyo Metropolitan Tama Medical Center, Fuchu-shi, Tokyo, Japan.
Case Rep Dermatol. 2022 Mar 29;14(1):71-76. doi: 10.1159/000524001. eCollection 2022 Jan-Apr.
The cutaneous manifestations of subacute cutaneous lupus erythematosus (SCLE), a subset of cutaneous lupus erythematosus, arise most often in sun-exposed areas. We report a case of SCLE with atypical distribution, following treatment with amlodipine. This highlighted a possible clue that can be used to clinically distinguish a drug-induced case from an idiopathic disorder. A 92-year-old Japanese woman presented with a 2-month history of progressive erythematous, papulosquamous rash, and annular plaques in non-sun-exposed sites with no systemic symptoms. Irbesartan/amlodipine besilate combination tablets were prescribed 8 months earlier for hypertension. The appearance of the skin eruptions, results of immunopathological findings, and temporal relationship between the rash and drugs were suggestive of a diagnosis of drug-induced SCLE, which was confirmed by the spontaneous resolution of these cutaneous eruptions within 4 weeks after cessation of amlodipine treatment. The evaluation of possible associations with medications should be performed in patients presenting with clinical features characterizing SCLE in atypical sites (non-sun-exposed areas).
亚急性皮肤型红斑狼疮（SCLE）是皮肤型红斑狼疮的一个亚型，其皮肤表现最常出现在暴露于阳光下的部位。我们报告一例接受氨氯地平治疗后出现非典型分布的SCLE病例。这凸显了一个可能的线索，可用于临床区分药物性病例与特发性疾病。一名92岁的日本女性，有2个月渐进性红斑、丘疹鳞屑性皮疹病史，非暴露部位出现环状斑块，无全身症状。8个月前因高血压开始服用厄贝沙坦/苯磺酸氨氯地平复方片剂。皮肤皮疹表现、免疫病理检查结果以及皮疹与药物的时间关系提示诊断为药物性SCLE，在停用氨氯地平治疗后4周内这些皮肤皮疹自行消退，证实了该诊断。对于在非典型部位（非暴露部位）出现具有SCLE临床特征的患者，应评估其与药物的可能关联。
