Cutaneous reactions induced by calcium channel blocker: high frequency of psoriasiform eruptions.
Fifteen cases with cutaneous reactions to calcium channel blockers (Ca-antagonist), dihydropiridine (including nicardipine, nifedipine, nisoldipine), verapamil, and diltiazem are reported. The patients from Yokohama City University Hospital and affiliated hospitals included 4 males and 11 females with cardiovascular diseases. Their average age was 64.7 (54 to 82) years. They had been taking Ca-antagonists for an average of 95 days (7 days to 10 years) before they developed dermatitis. The frequency of reactions to Ca-antagonists was high with diltiazem (5/16:31.25%) and dihydropyridine (7/16:43.75%), including nifedipine (4/7), nisoldipine (1/7), and nicardipine (2/7). Stevens-Johnson syndrome (MCOS) was associated only with verapamil. A notable type of eruption was the psoriasiform type, including exacerbation of psoriasis, which was resolved or easily controlled after discontinuation of the drug. Provocation tests verified the Ca-antagonist as the cause in 7 cases of psoriasiform eruption. The frequency of positive patch tests to Ca-antagonists was low except for diltiazem. Patch tests with diltiazem showed positive reactions in 54% (7 of 13 patients), based on our experience and papers published in Japan. Ca-antagonists are occasional causes of a wide spectrum of cutaneous reactions and should also be considered as causative factors in patients who develop psoriasiform eruptions or in patients whose psoriasis is exacerbated while using these drugs.
Kitamura
K
K
Department of Dermatology, Yokohama City University, Urafune Hospital, Japan.
Kanasashi
M
M
Suga
C
C
Saito
S
S
Yoshida
S
S
Ikezawa
Z
Z
D000368:Aged; D002121:Calcium Channel Blockers / Q000009:adverse effects*; D003875:Drug Eruptions; D004892:Erythema Multiforme / Q000139:chemically induced / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000139:chemically induced* / Q000473:pathology; D012867:Skin / Q000473:pathology
D002121:Calcium Channel Blockers