title: Clopidogrel: a possible exacerbating factor for psoriasis.
abstract: A 64-year-old man developed palmoplantar pustulosis eventuating into palmoplantar pustular psoriasis following treatment with diltiazem, atenolol, aspirin and atorvastatin for suspected coronary artery disease (CAD). Treatment for psoriasis, stopping atenolol and substituting aspirin with clopidogrel did not benefit. Subsequently, he stopped all his drugs and did not develop psoriasis or symptoms/signs of CAD. Re-challenge with oral clopidogrel precipitated his skin lesions. This case has implications for patients having psoriasis and cardiovascular comorbidity where clopidogrel/ticlopidine or aspirin may not be a useful alternative.
authors.affiliation: Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda) - 176001, Himachal Pradesh, India.
authors.forename: Vikram K
authors.initials: VK
authors.lastname: Mahajan
authors.affiliation: Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda) - 176001, Himachal Pradesh, India.
authors.forename: Gayatri
authors.initials: G
authors.lastname: Khatri
authors.affiliation: Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda) - 176001, Himachal Pradesh, India.
authors.forename: Neel
authors.initials: N
authors.lastname: Prabha
authors.affiliation: Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda) - 176001, Himachal Pradesh, India.
authors.forename: C
authors.initials: C
authors.lastname: Abhinav
authors.affiliation: Department of Dermatology, Venereology & Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda) - 176001, Himachal Pradesh, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Sharma
mesh_terms: D000077144:Clopidogrel; D003324:Coronary Artery Disease / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011565:Psoriasis / Q000139:chemically induced*; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: Adverse drug reactions; antiplatelet therapy; clopidogrel; psoriasis triggers; pustular psoriasis