12/28/2023 0 Comments Amlodipine pinpoint rash![]() ![]() A 2013 study done on usage of calcium channel blockers in the elderly, showed that they were related to chronic eczematous eruptions in this age group. Mean age of patients with CCB related cutaneous reactions was 65 years in one study, with the percentage of affected women being higher than that of men. Serious cutaneous syndromes include Steven-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and hypersensitivity syndrome. Skin reactions which have been described following use of CCBs include angioedema, exfoliative dermatitis, erythema multiforme, erythema nodosum, rash with photosensitivity, psoriasiform eruptions, urticarial vasculitis, vasculitic leg ulcers, gingival hyperplasia, erythromelalgia, facial telangiectasia, pemphigus foliaceus and nonthrombcytopenic purpura. Cutaneous adverse drug reactions are most commonly associated with diltiazem, among all CCBs. Side effects which have been ascribed to these drugs include headache, nausea, weight gain, oedema and depression. The calcium channel blockers (CCBs) include dihydropyridines, phenylalkylamines, benzothiazepines and piperazines. Skin manifestations which follow amlodipine therapy, that have been reported, include urticaria, alopecia, dermatitis, erythema multiformae, maculopapular rash or an erythematous rash like purpura. Her purpura gradually disappeared after a week, without further recurrence.Īmlodipine is a calcium channel-blocker which acts on cardiac and smooth muscles and which prevents trans-membrane influx of calcium, that causes reduction of peripheral resistance. ![]() Suspecting calcium channel-blocker (CCB) purpura, enalapril (5mg) and dihydrochlorothiazide (12.5mg) were substituted for amlodipine. Complete blood counts, bleeding time, clotting time, prothrombin time, activated partial thromboplastin time, creatinine and blood sugars were normal. She had been worked up for these complaints and had been told that her blood tests were normal. There were no other bleeding complaints or histories which suggested an autoimmune disease. There was also a history of gum bleeding when she used a toothbrush and she had resorted to using her fingers. There was no history of use of any other drugs. This had begun 10 days following initiation of amlodipine for controlling her hypertension. On reviewing her history, she was found to have a history of spontaneous purpura since the previous three months. Ten minutes later, some of them had progressed to ecchymosis, which gradually resolved over three days. Following use of a tourniquet on her right arm to obtain a blood sample, she had developed multiple petechiae and non-palpable purpura (>40) on her right forearm. She was evaluated and was advised to return with blood sugar and lipid profile results. ![]() Her systemic examination was within normal limits. She had been prescribed amlodipine 5mgOD and her compliance and control had been adequate. She had lived in north India for her entire life and had moved to our city only 2 weeks ago. ![]() This 60-year-old hypertensive lady for the preceding three months, came to the Out-Patients Department of our hospital for a general check-up. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |