Purpuric oral and cutaneous lesions in a case of drug-induced thrombocytopenia.
This case, from all appearances, seems to constitute a case of secondary thrombocytopenia caused by drugs. Whether the etiology is one of over-dosage achieved when the two drugs, propranolol and disulfiram, were used in combination, or the interaction of the two drugs, or a response to disulfiram is difficult to state definitely. The use of propranolol alone does not seem to be the triggering factor because the patient resumed use of the drug without ill effect. Either an overdosage, exceeding a triggering threshold, was achieved in the combined usage of these two potentially purpuric drugs, or a reaction to disulfiram occurred subsequent to prior sensitizing exposure to this drug. The case does point out that the practitioner, whether dental or medical, should take a careful drug history--particularly in cases of purpura but also in other conditions, such as xerostomia, lichenoid reactions, and burning mouth or tongue. A copy of a current Physician's Desk Reference should be available in every dental or medical office.
D004221:Disulfiram / Q000009:adverse effects*; D004338:Drug Combinations; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009059:Mouth Diseases / Q000139:chemically induced*; D011433:Propranolol / Q000009:adverse effects*; D011696:Purpura, Thrombocytopenic / Q000139:chemically induced*; D012871:Skin Diseases / Q000139:chemically induced*
D004338:Drug Combinations; D011433:Propranolol; D004221:Disulfiram