Qureshi Simal A, Finch Sarah E, Pratt Michelle E
Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
Department of Pathology, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.
SAGE Open Med Case Rep. 2024 Nov 28;12:2050313X241284003. doi: 10.1177/2050313X241284003. eCollection 2024.
Exposure to certain drugs can trigger new-onset psoriasis or flaring of existing psoriatic disease. The clinical presentation of drug-induced psoriasis can vary, and although there are features suggestive of drug-induced psoriasis, there are currently no standardized criteria to differentiate it from conventional psoriasis. Patients may present with localized psoriasiform plaques, or variants such as palmoplantar, nail disease, or widespread erythroderma. Histopathology of drug-induced psoriasis can also be indistinguishable from conventional psoriasis but features suggestive of drug-induced include lack of suprapapillary epidermal thinning, a limited number of Munro microabscesses, and the presence of eosinophils and/or a lichenoid reaction pattern. We report a case of suspected drug-induced psoriasis due to dapagliflozin (Farxiga) in a 76-year-old man. Evidence indicating this to be a probable drug-induced reaction includes the sudden onset of symptoms; atypical pathology with the presence of eosinophils; and clearance of the lesions upon discontinuation of the suspected causative drug.
接触某些药物可引发新发银屑病或使现有的银屑病病情加重。药物性银屑病的临床表现可能各异,尽管存在一些提示药物性银屑病的特征,但目前尚无标准化标准将其与传统银屑病区分开来。患者可能出现局限性银屑病样斑块,或诸如掌跖部、甲病或泛发性红皮病等变体。药物性银屑病的组织病理学表现也可能与传统银屑病难以区分,但提示药物性的特征包括无乳头上方表皮变薄、Munro微脓肿数量有限以及存在嗜酸性粒细胞和/或苔藓样反应模式。我们报告一例76岁男性因达格列净(安达唐)疑似药物性银屑病的病例。表明这可能是药物性反应的证据包括症状突然出现;存在嗜酸性粒细胞的非典型病理学表现;以及停用疑似致病药物后皮损消退。