Management of refractory telaprevir-induced dermatitis using oral corticosteroids.
We present a series of 12 patients with telaprevir-induced skin toxicity. Some patients presented eczematous lesion, while others presented nonscaling macular lesions that became more purpuric in the lower limbs. Seven of the 12 patients had skin lesions affecting more than 50% of the body surface area, but none had systemic manifestations. Oral corticosteroids, prescribed in 7 patients, produced symptomatic improvement, and the response to the antiviral treatment in these patients was good. The 3 biopsies performed showed a superficial perivascular dermatitis with foci of red cell extravasation. Monitoring is central to the management of skin reactions secondary to the protease inhibitors, as severe drug eruptions have been reported. Treatment is usually symptomatic. We describe 7 cases in which oral corticosteroids-whose use continues to be controversial -were administered as a last resort for the control of pruritus.
Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España. Electronic address: jgarcila@gmail.com.
J
J
Garcias-Ladaria
Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España.
A
A
Pérez-Ferriols
Servicio de Farmacia, Hospital General Universitario de Valencia, Valencia, España.
P
P
Ortega-García
Servicio de Patología Digestiva, Hospital General Universitario de Valencia, Valencia, España.
M
M
Diago
D000284:Administration, Oral; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003875:Drug Eruptions / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D004359:Drug Therapy, Combination; D004485:Eczema / Q000139:chemically induced / Q000188:drug therapy; D004643:Emollients / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000009:adverse effects* / Q000627:therapeutic use; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D011537:Pruritus / Q000188:drug therapy / Q000209:etiology; D011693:Purpura / Q000139:chemically induced / Q000188:drug therapy
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D004643:Emollients; D006633:Histamine Antagonists; D009842:Oligopeptides; C486464:telaprevir; D011241:Prednisone
Dermatitis; Eccema; Eczema; Hepatitis C; Inhibidores de la proteasa; Protease inhibitors; Telaprevir; Toxicoderma; Toxicodermia