title: Proton pump inhibitor-induced exfoliative dermatitis: A case report.
abstract: A 74-year-old female patient was admitted to hospital following a road accident with pains in the chest, abdomen, waist, back, nose, left wrist and lower limbs. After 1 week, the patient presented with gastrointestinal bleeding, and thus was treated with protein pump inhibitors (PPIs), including lansoprazole, esomeprazole and omeprazole enteric-coated tablets, in order to inhibit acid secretion and attenuate bleeding. However, the patient developed skin rashes on the chest and right lower limb and foot 28 days following treatment initiation. The skin rashes spread and ulcerated after 3 days, and were associated with tracheal mucosal injury and hemoptysis. Subsequently, treatment of the patient with PPIs was terminated, after which the tracheal hemoptysis and skin rashes markedly improved. In addition, no new skin rashes appeared following termination of the PPI treatment. In the present case, long-term treatment of an elderly patient with PPIs may have induced exfoliative dermatitis, due to hepatic ischemia, hypoxia and acute renal failure, which may have decreased the metabolism of PPIs, resulting in the accumulation of PPI metabolites.
authors.affiliation: Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China.
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Qiu
authors.affiliation: Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China.
authors.forename: Lien
authors.initials: L
authors.lastname: He
authors.affiliation: Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China.
authors.forename: Yinling
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China.
authors.forename: Haojing
authors.initials: H
authors.lastname: Song
authors.affiliation: Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China.
authors.forename: Wanjun
authors.initials: W
authors.lastname: Bai
authors.affiliation: Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China.
authors.forename: Meiling
authors.initials: M
authors.lastname: Yu
keywords: exfoliative dermatitis; proton pump inhibitors