Tomasovic M, Sinik M, Gluvic Z, Zafirovic S, Isenovic Esma R
University of Belgrade, School of Medicine, Zemun Clinical Hospital, Department of Endocrinology and Diabetes.
University of Belgrade, VINČA Institute of Nuclear Sciences - National Institute of the Republic of Serbia, Department of Radiobiology and Molecular Genetics, Belgrade, Serbia.
Acta Endocrinol (Buchar). 2023 Jul-Sep;19(3):380-385. doi: 10.4183/aeb.2023.380. Epub 2024 Feb 1.
Propylthiouracil (PTU) could cause lupus or vasculitis-like hypersensitivities thus interfering with some other concomitant diseases.
Clinicians must be aware of the side effects of medications, particularly after their introduction and long-term use. Some clinical manifestations may be similar to well-known drug side effects or hypersensitivity. Every unusual clinical scenario related to drug use must be evaluated individually and thoroughly.
Hands and feet skin changes were observed several days after PTU administration in a male patient with severe diffuse toxic goitre. A complete blood count, biochemistry analyses, thyroid function tests and antibodies, and immunology analyses were performed.
As the skin changes were distributed regionally, liver function tests were normal, and there were no signs of clinical deterioration, it was decided to continue PTU treatment and monitor the patient. The initial maculopapular rash quickly turned vesicular, then scaly. After two weeks, the skin changes were wholly restored, with no scarring. Hand, Foot, and Mouth disease (HFMD) was diagnosed after a thorough epidemiological survey and clinical workout.
Our case study demonstrates that skin changes associated with HFMD may resemble those associated with PTU-induced vasculitis.
丙硫氧嘧啶（PTU）可引发狼疮或血管炎样超敏反应，从而干扰其他一些伴随疾病。
临床医生必须了解药物的副作用，尤其是在药物引入和长期使用之后。一些临床表现可能类似于已知的药物副作用或超敏反应。每一个与药物使用相关的不寻常临床情况都必须进行单独且全面的评估。
在一名患有严重弥漫性毒性甲状腺肿的男性患者服用PTU几天后，观察其手足皮肤变化。进行了全血细胞计数、生化分析、甲状腺功能测试及抗体检测以及免疫学分析。
由于皮肤变化呈区域性分布，肝功能测试正常，且无临床恶化迹象，因此决定继续PTU治疗并对患者进行监测。最初的斑丘疹迅速变成水疱，然后结痂。两周后，皮肤变化完全恢复，无瘢痕形成。经过全面的流行病学调查和临床检查后，诊断为手足口病（HFMD）。
我们的病例研究表明，与手足口病相关的皮肤变化可能类似于与PTU诱导的血管炎相关的皮肤变化。
