Suspected cutaneous drug toxicity in rheumatoid arthritis--an evaluation.
Cutaneous toxicity from drugs used to treat RA is a major perceived problem. Over a 2-yr period we have prospectively reviewed 114 patients with a suspected adverse cutaneous reaction to anti-rheumatic drugs. In 71 (62%), the rash was thought to be unrelated to drug therapy. This group included 10 in whom the rash had resolved before review (usually < 1 week), 38 with a rash related to their rheumatoid disease and 23 with eruptions unrelated to either drugs or arthritis. Forty-three (38%) patients had rashes thought to be related to their drug therapy. Gold therapy (both oral and intramuscular) was implicated most frequently (31 patients). However, the majority of these (23) had a pityriasiform/discoid eczematous eruption that responded to potent topical steroids occasionally with a reduction in gold dosage. In this sample it was possible to continue drug therapy in 82% of patients with what were initially thought to be cutaneous adverse drug reactions. Careful evaluation should allow a majority of patients to continue drug therapy from which they are often gaining benefit.
Wilkinson
S M
SM
Dermatology Department, North Staffordshire Hospital Centre, Stoke-on-Trent.
Smith
A G
AG
Davis
M J
MJ
Mattey
D L
DL
Dawes
P T
PT
D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002196:Capillaries / Q000187:drug effects / Q000473:pathology; D002738:Chloroquine / Q000009:adverse effects; D016903:Drug Monitoring; D006801:Humans; D050607:Organogold Compounds; D010392:Pemphigus / Q000139:chemically induced; D010396:Penicillamine / Q000009:adverse effects; D011446:Prospective Studies; D011537:Pruritus / Q000139:chemically induced; D012189:Retrospective Studies; D012867:Skin / Q000098:blood supply* / Q000187:drug effects; D012871:Skin Diseases / Q000139:chemically induced*; D017443:Skin Diseases, Eczematous / Q000139:chemically induced; D014657:Vasculitis / Q000139:chemically induced
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D050607:Organogold Compounds; D002738:Chloroquine; D010396:Penicillamine