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CD30+ lymphomatoid drug reactions.
- 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.
- Subjects :
- Adrenergic beta-Antagonists adverse effects
Aged
Aged, 80 and over
Amines adverse effects
Amlodipine adverse effects
Anti-Bacterial Agents adverse effects
Anticonvulsants adverse effects
Biomarkers analysis
Biopsy
Calcium Channel Blockers adverse effects
Cyclohexanecarboxylic Acids adverse effects
Drug Eruptions pathology
Erythema chemically induced
Erythema immunology
Female
Gabapentin
Humans
Immunohistochemistry
Levofloxacin
Lymphocytes drug effects
Lymphocytes pathology
Lymphoproliferative Disorders chemically induced
Lymphoproliferative Disorders pathology
Male
Metoprolol adverse effects
Middle Aged
Ofloxacin adverse effects
Predictive Value of Tests
Pseudolymphoma chemically induced
Pseudolymphoma pathology
Selective Serotonin Reuptake Inhibitors adverse effects
Sertraline adverse effects
Skin drug effects
Skin pathology
gamma-Aminobutyric Acid adverse effects
Drug Eruptions immunology
Ki-1 Antigen analysis
Lymphocytes immunology
Lymphoproliferative Disorders immunology
Pseudolymphoma immunology
Skin immunology
Subjects
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