Nadella Harshita, Vilar Nicole, Nochimson Ross
Rheumatology and Immunology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA.
Internal Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA.
Cureus. 2023 Dec 10;15(12):e50273. doi: 10.7759/cureus.50273. eCollection 2023 Dec.
Many anticoagulants are indicated as prophylaxis and treatment for conditions that may lead to thromboembolisms or atrial fibrillation. Among those, apixaban, a reversible direct inhibitor of factor Xa, is one of the most popular. Apixaban is known to cause a variety of side effects; however, for this paper, the focus is on hypersensitivity reactions. Although several cases will be referenced from the literature, we present a case with a history of a dermatological disease before the use of a direct oral anticoagulant. A 74-year-old female patient with a history of pemphigus vulgaris and a diagnosis of pulmonary embolism and right distal vein thrombosis managed with apixaban presented with a pruritic coalescent erythematous dermatitis throughout her torso, back, and lower extremities three days post-apixaban treatment. In accordance with her physical examination, the apixaban regimen was withdrawn, and oral dabigatran, a direct thrombin inhibitor, was initiated. At the patient's five-day follow-up, clinical improvement was noted. Through clinical diagnosis, it is believed that this dermatitis was a reaction to the apixaban treatment course.
许多抗凝剂被指定用于预防和治疗可能导致血栓栓塞或心房颤动的病症。其中，阿哌沙班，一种可逆的Xa因子直接抑制剂，是最常用的药物之一。已知阿哌沙班可引起多种副作用；然而，在本文中，重点是过敏反应。虽然将从文献中引用几个病例，但我们展示了一例在使用直接口服抗凝剂之前有皮肤病病史的病例。一名74岁女性患者，有寻常型天疱疮病史，诊断为肺栓塞和右下肢远端静脉血栓形成，使用阿哌沙班治疗，在阿哌沙班治疗三天后，其躯干、背部和下肢出现瘙痒性融合性红斑性皮炎。根据体格检查结果，停用了阿哌沙班治疗方案，并开始使用直接凝血酶抑制剂达比加群口服。在患者五天的随访中，观察到临床症状有所改善。通过临床诊断，认为这种皮炎是对阿哌沙班治疗过程的反应。
