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CD30+ lymphomatoid drug reactions.

Authors :
Pulitzer MP
Nolan KA
Oshman RG
Phelps RG
Source :
The American Journal of dermatopathology [Am J Dermatopathol] 2013 May; Vol. 35 (3), pp. 343-50.
Publication Year :
2013

Abstract

We report 5 cases of cutaneous CD30+ lymphomatoid drug reactions that occurred shortly after the onset of drug exposure and resolved promptly upon withdrawal of the offending agents. The cases showed protean dermatologic manifestations ranging from diffuse erythema with desquamation to macules, papules, and annular plaques. The suspect drugs were amlodipine (a calcium channel blocker) for 2 cases, sertraline (a selective serotonin reuptake inhibitor) for 1 case, gabapentin for 1 case, and levofloxacin (a fluoroquinolone) versus cefepime (a fourth generation cephalosporin), and metoprolol (a beta blocker), in the fifth case. The histopathologic findings included varying combinations of spongiotic dermatitis, lichenoid infiltrates, and interface dermatitis with a dermal infiltrate of large atypical lymphocytes. Three of the 5 cases contained as much as 30% CD30+ staining of all lymphocytes, whereas the remaining 2 showed 5%-15% positivity. Three patients had a history of allergy or immune dysregulation. Increased knowledge of CD30 positivity in lymphomatoid drug reactions may be relevant in an era of targeted drug therapies. Recognition of these findings may help clinicians to tailor appropriate clinical evaluation and treatment including a review of medications and the removal of possible offending agents.

Details

Language :
English
ISSN :
1533-0311
Volume :
35
Issue :
3
Database :
MEDLINE
Journal :
The American Journal of dermatopathology
Publication Type :
Academic Journal
Accession number :
23328787
Full Text :
https://doi.org/10.1097/DAD.0b013e31826bc1e5