CASE REPORT - Delayed hypersensitivity to Plaquenil manifested by two different types of cutaneous eruptions in the same patient

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Allergol Immunopathol (Madr). 2006 Jul-Aug;34(4):174-5.

Delayed hypersensitivity to hydroxychloroquine manifested by two

different types of cutaneous eruptions in the same patient.

Pérez-Ezquerra PR, de Barrio Fernández M, de Castro Martínez FJ, Ruiz

Hornillos FJ, Prieto García A.

Servicio de Alergia, Hospital Gregorio Marañon, Madrid, Spain.

Hydroxychloroquine (HXQ) sulphate is a synthetic antimalaria drug that

is widely used in rheumatology due to its immunosuppressive

properties. Delayed-type sensitization to this drug is rare. A

47-year-old woman diagnosed with HLA B27 ankylosing spondylitis was

treated with HXQ for 22 days and had to discontinue the drug due to

gastric intolerance. Five days later the patient developed erythema

multiforme (EM) with an extensive and unusual distribution. Patch test

with 10% HXQ in DMSO were positive at 48 hours. Eight days later a

generalized pruriginous erythematous papular exanthema developed, and

a skin biopsy was obtained. The first reaction was EM. Patch-testing

elicited systemic eczematous contact dermatitis. We report two

different clinical patterns of delayed hypersensitivity in the same

patient and with the same drug.

PMID: 16964632

http://www.ncbi.nlm.nih.gov/pubmed/16964632

Not an MD