CASE REPORT - Lichenoid drug reaction to Arava

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Ann Dermatol Venereol. 2003 Apr;130(4):435-7.

[Lichenoid drug reaction to leflunomide]

[Article in French]

Canonne-Courivaud D, Carpentier O, Dejobert Y, Hachulla E, Delaporte E.

Clinique de Dermatologie, Hopital Claude-Huriez, CHRU Lille.

INTRODUCTION: Leflunomide (Arava) is an immunomodulator, recently introduced

for systemic treatment of rheumatoid arthritis. We report the first case of

lichenoid drug reaction due to this drug. CASE REPORT: A sixty-four year-old

woman received leflunomide for rheumatoid arthritis. Two months after

initiation of treatment, pruritus and lichenoid papules appeared on her

hands and subsequently on her arms and her trunk, with a few bullous

lesions. A skin biopsy was evocative for the diagnosis of drug induced

lichenoid eruption. The treatment was stopped, and a wash out with

colestyramine and topical corticotherapy resulted in dramatic improvement.

No relapse was observed. Two months later, patch-tests with leflunomide

diluted to 30 p. 100 in white petrolatum were negative.

DISCUSSION: Side effects of leflunomide are frequent, generally benign for

the cutaneous features. In our case, the delay, clinical and histological

aspect and improvement on withdrawal of the drug emphasize the imputability

of leflunomide. Few cases have been reported with others immunomodulators.

PMID: 12843855

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

2843855

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