Fluticasone-associated cutaneous allergic granulomatous vasculitis: an underrecognized but important cause of drug-induced cutaneous Churg-Strauss syndrome.
Allergic granulomatous vasculitis, or Churg-Strauss syndrome, is a small vessel, multisystem vasculitis that can affect multiple organs. It is usually idiopathic, but recent case reports have implicated leukotriene receptor antagonists (LTRA) and inhaled corticosteroids in the development of this rare syndrome. We report a case that acutely developed skin-limited Churg Strauss-like cutaneous allergic granulomatous vasculitis after initiating therapy with inhaled fluticasone and salmeterol for poorly controlled asthma symptoms. Our result thus highlights the importance of keeping the differential diagnosis of drug-induced Churg-Strauss syndrome in patients who have recently been prescribed inhaled steroids like fluticasone when they present with rashes of varying severity.
Nepal
Manoj
M
Department of Medicine, Mercy Catholic Medical Center, Drexel University, Darby, PA 19023, USA. manojnepal@gmail.com
Padma
Hymavati
H
D000280:Administration, Inhalation; D000328:Adult; D000730:Androstadienes / Q000008:administration & dosage / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy; D015267:Churg-Strauss Syndrome / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D005260:Female; D000068298:Fluticasone; D006801:Humans; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000150:complications
D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D000068298:Fluticasone