1. Photo-distributed neutrophilic drug eruption and adult respiratory distress syndrome associated with antidepressant therapy.
- Author
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Mecca P, Tobin E, and Andrew Carlson J
- Subjects
- Acute Disease, Adult, Antipsychotic Agents adverse effects, Citalopram adverse effects, Diagnosis, Differential, Drug Eruptions drug therapy, Drug Eruptions etiology, Drug Therapy, Combination, Female, Glucocorticoids therapeutic use, Humans, Perphenazine adverse effects, Respiratory Distress Syndrome etiology, Sweet Syndrome diagnosis, Amoxapine adverse effects, Antidepressive Agents, Second-Generation adverse effects, Drug Eruptions pathology, Neutrophils pathology, Respiratory Distress Syndrome pathology
- Abstract
Drug reactions are well-known complications of antidepressant therapy, often related to photosensitization. Herein is reported a singular case of antidepressant (amoxapine and citalopram) and anxiolytic related (perphenazine) photo-distributed neutrophilic dermatosis and adult respiratory distress syndrome (ARDS). The clinicopathologic findings displayed overlapping features with drug-induced Sweet's syndrome, acute generalized exanthematous pustulosis (AGEP), and so-called sterile neutrophilic folliculitis with perifollicular vasculopathy. Of the three medications, only amoxapine has been associated with AGEP. Treatment with high-dose systemic corticosteroids and cessation of drug therapy was followed by rapid resolution of the cutaneous eruption and respiratory distress. The possibility that neutrophil infiltration of the lung and/or accumulation of neutrophils in the skin and blood served as a source for reactive oxygen species, leading to lung injury and subsequent ARDS, is discussed.
- Published
- 2004
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