title: The spectrum of cutaneous reactions associated with diltiazem: three cases and a review of the literature.
abstract: BACKGROUND
  Cutaneous reactions ranging from exanthems to severe adverse events have been reported in association with calcium channel blockers.
  
  
  OBJECTIVE
  Our purpose was to document cutaneous eruptions resulting from use of diltiazem.
  
  
  METHODS
  We describe three patients who experienced a cutaneous reaction (i.e., hypersensitivity syndrome reaction, pruritic exanthematous eruption, and acute generalized exanthematous pustulosis) possibly induced by diltiazem, summarize adverse reaction reports obtained from the Health Protection Branch, and review the literature on calcium channel blockers inducing cutaneous reactions.
  
  
  RESULTS
  Of the 315 cases of possible diltiazem-induced adverse reactions that were reported to the Health Protection Branch, 151 (48%) were cutaneous. The number of diltiazem-induced cutaneous events was significantly greater than those induced by either nifedipine or verapamil. However, no difference was found in the proportion of serious cutaneous adverse events to either of the three drugs.
  
  
  CONCLUSIONS
  Diltiazem has been associated with a variety of cutaneous reactions that appear to occur more frequently than with other calcium channel blockers.
authors.affiliation: Department of Medicine, Sunnybrook Health Science Centre and the University of Toronto, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Knowles
authors.forename: A K
authors.initials: AK
authors.lastname: Gupta
authors.forename: N H
authors.initials: NH
authors.lastname: Shear
mesh_terms: D002121:Calcium Channel Blockers / Q000009:adverse effects*; D004110:Diltiazem / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D004342:Drug Hypersensitivity / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D002121:Calcium Channel Blockers; D004110:Diltiazem