title: [Digoxin-related leukocytoclastic vasculitis in a very elderly woman: A case report].
abstract: Even though digoxin causes many side effects, few cases of skin involvement are recorded in the French Pharmacovigilance Database. We report a case of leukocytoclastic vasculitis (LV) very probably due to digoxin. A 91-year-old woman, hospitalized following a fall, presented cardiac decompensation in a context of rapid atrial fibrillation requiring treatment with digoxin. Eight days later, a rash appeared on her back and trunk. It was neither itchy, nor painful and persisted despite local treatment. There were no other clinical anomalies. After a few days, the rash spread with appearance of bullous lesions, ulcerations and a necrosis on lymphedema of the two legs. Among the complementary examinations, skin biopsy revealed LV with necrosis and subepidermal detachment suggested toxic dermal necrolysis, while direct immunofluorescence was negative. The rash resolved progressively once the digoxin was stopped. The pharmacovigilance department recorded that digoxin was the probable cause. The evidence allowed us to conclude that digoxin was the cause.
authors.affiliation: Centre de convalescence gériatrique de Fontaine, 67, route d'Ahuy, 21210 Fontaine-les-Dijon, France.
authors.forename: S
authors.initials: S
authors.lastname: Ludwig-Béal
authors.affiliation: Service de médecine interne et maladies systémiques, CHU Dijon bocage central, 2, boulevard de Lattre-de-Tassigny, 21000 Dijon, France.
authors.forename: N
authors.initials: N
authors.lastname: Vernier
authors.affiliation: Service de médecine interne gériatrie, hôpital de Champmaillot CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Popitean
authors.affiliation: Service de médecine interne gériatrie, hôpital de Champmaillot CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Levêque
authors.affiliation: Centre régional de pharmacovigilance, CHU Dijon bocage central, pôle des vigilances, 2, boulevard de Lattre-de-Tassigny, 21000 Dijon, France.
authors.forename: S
authors.initials: S
authors.lastname: Combret
authors.affiliation: Service de médecine interne gériatrie, hôpital de Champmaillot CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France; Inserm U1093 : cognition, action et plasticité sensorimotrice (CAPS), université de Bourgogne Franche-Comté, BP 27877, 21078 Dijon cedex, France. Electronic address: patrick.manckoundia@chu-dijon.fr.
authors.forename: P
authors.initials: P
authors.lastname: Manckoundia
mesh_terms: D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000188:drug therapy; D001706:Biopsy; D004077:Digoxin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000473:pathology
chemical_list: D004077:Digoxin
keywords: Adverse side effects; Digoxin; Digoxine; Effets indésirables; Leukocytoclastic vasculitis; Vascularite leucocytoclasique