Akdogan Raziye E, Chen Jennifer, Varon Alberto, Muradova Elnara, Fusco Joseph
Internal Medicine, University of Connecticut School of Medicine, Farmington, USA.
Dermatology, University of Connecticut School of Medicine, Farmington, USA.
Cureus. 2023 Feb 9;15(2):e34800. doi: 10.7759/cureus.34800. eCollection 2023 Feb.
Currently, guidelines recommend ticagrelor over clopidogrel as part of dual antiplatelet therapy with aspirin in treating individuals with acute coronary syndrome. As there is an increased usage of ticagrelor, it is important to keep in mind uncommon adverse events, including hypersensitivity skin reactions. To date, only a few studies have been published regarding ticagrelor-induced skin eruptions. Additionally, there is no consensus on antiplatelet therapy management after a hypersensitivity reaction to antiplatelet agents. Hereinafter, we describe a case of an 81-year-old female who presents with a diffuse erythematous hypersensitivity eruption, including palms and soles, secondary to ticagrelor use. Ticagrelor transitioned to clopidogrel, and the patient was started on steroid taper with an antihistamine. The patient's rash progressively improved after the treatment. Our case demonstrates a rare adverse effect of ticagrelor, which needs prompt diagnosis and switching to one of the thienopyridines to prevent thrombosis.
目前，指南推荐在急性冠状动脉综合征患者中使用替格瑞洛而非氯吡格雷作为阿司匹林双联抗血小板治疗的一部分。随着替格瑞洛使用量的增加，记住包括超敏皮肤反应在内的罕见不良事件很重要。迄今为止，关于替格瑞洛引起的皮肤疹仅有少数研究发表。此外，对于抗血小板药物过敏反应后的抗血小板治疗管理尚无共识。在此，我们描述一例81岁女性患者，其因使用替格瑞洛继发出现包括手掌和足底在内的弥漫性红斑超敏疹。将替格瑞洛换为氯吡格雷，并开始给予患者使用抗组胺药的同时逐渐减量使用类固醇。治疗后患者皮疹逐渐改善。我们的病例展示了替格瑞洛一种罕见的不良反应，需要及时诊断并换用噻吩并吡啶类药物之一以预防血栓形成。
