title: CD30+ lymphomatoid drug reactions.
abstract: We report 5 cases of cutaneous CD30+ lymphomatoid drug reactions that occurred shortly after the onset of drug exposure and resolved promptly upon withdrawal of the offending agents. The cases showed protean dermatologic manifestations ranging from diffuse erythema with desquamation to macules, papules, and annular plaques. The suspect drugs were amlodipine (a calcium channel blocker) for 2 cases, sertraline (a selective serotonin reuptake inhibitor) for 1 case, gabapentin for 1 case, and levofloxacin (a fluoroquinolone) versus cefepime (a fourth generation cephalosporin), and metoprolol (a beta blocker), in the fifth case. The histopathologic findings included varying combinations of spongiotic dermatitis, lichenoid infiltrates, and interface dermatitis with a dermal infiltrate of large atypical lymphocytes. Three of the 5 cases contained as much as 30% CD30+ staining of all lymphocytes, whereas the remaining 2 showed 5%-15% positivity. Three patients had a history of allergy or immune dysregulation. Increased knowledge of CD30 positivity in lymphomatoid drug reactions may be relevant in an era of targeted drug therapies. Recognition of these findings may help clinicians to tailor appropriate clinical evaluation and treatment including a review of medications and the removal of possible offending agents.
authors: Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors: Melissa P
authors: MP
authors: Pulitzer
authors: Katherine A
authors: KA
authors: Nolan
authors: Robin G
authors: RG
authors: Oshman
authors: Robert G
authors: RG
authors: Phelps
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects; D000368:Aged; D000369:Aged, 80 and over; D000588:Amines / Q000009:adverse effects; D017311:Amlodipine / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D002121:Calcium Channel Blockers / Q000009:adverse effects; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects; D003875:Drug Eruptions / Q000276:immunology* / Q000473:pathology; D004890:Erythema / Q000139:chemically induced / Q000276:immunology; D005260:Female; D000077206:Gabapentin; D006801:Humans; D007150:Immunohistochemistry; D017730:Ki-1 Antigen / Q000032:analysis*; D064704:Levofloxacin; D008214:Lymphocytes / Q000187:drug effects / Q000276:immunology* / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000139:chemically induced / Q000276:immunology* / Q000473:pathology; D008297:Male; D008790:Metoprolol / Q000009:adverse effects; D008875:Middle Aged; D015242:Ofloxacin / Q000009:adverse effects; D011237:Predictive Value of Tests; D019310:Pseudolymphoma / Q000139:chemically induced / Q000276:immunology* / Q000473:pathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects; D020280:Sertraline / Q000009:adverse effects; D012867:Skin / Q000187:drug effects / Q000276:immunology* / Q000473:pathology; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects
chemical_list: D000319:Adrenergic beta-Antagonists; D000588:Amines; D017311:Amlodipine; D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D015415:Biomarkers; D002121:Calcium Channel Blockers; D003509:Cyclohexanecarboxylic Acids; D000077206:Gabapentin; D017730:Ki-1 Antigen; D064704:Levofloxacin; D008790:Metoprolol; D015242:Ofloxacin; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline; D005680:gamma-Aminobutyric Acid