{"id":16648,"date":"2020-04-29T03:37:24","date_gmt":"2020-04-29T06:37:24","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/wiki\/erupcion-de-drogas-liquenoides\/"},"modified":"2020-10-30T07:36:49","modified_gmt":"2020-10-30T10:36:49","slug":"lichenoid-drug-eruption-2","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/en\/wiki\/erupcion-de-drogas-liquenoides\/","title":{"rendered":"Lichenoid drug rash"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/erupcion-de-drogas-liquenoides\/#Que-es-un-liquenoide-farmaco-erupcion\" >What is a lichenoid rash drug?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/erupcion-de-drogas-liquenoides\/#%C2%BFQuien-contrae-una-erupcion-de-drogas-liquenoides\" >Who gets a lichenoid drug rash?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/erupcion-de-drogas-liquenoides\/#%C2%BFCuales-son-las-caracteristicas-clinicas-de-la-erupcion-de-un-medicamento-liquenoide\" >What are the clinical features of a lichenoid drug rash?<\/a><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/erupcion-de-drogas-liquenoides\/#Erupcion-de-drogas-liquenoides\" >Lichenoid drug rash<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/erupcion-de-drogas-liquenoides\/#%C2%BFComo-se-diagnostica-la-erupcion-de-un-medicamento-liquenoide\" >How is a lichenoid drug rash diagnosed?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/erupcion-de-drogas-liquenoides\/#%C2%BFCual-es-el-tratamiento-para-la-erupcion-de-la-droga-liquenoide\" >What is the treatment for lichenoid drug rash?<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"Que-es-un-liquenoide-farmaco-erupcion\"><\/span>What is a <span class=\"term\" data-term-id=\"168\">lichenoid<\/span> drug <span class=\"term\" data-term-id=\"704\">eruption<\/span>?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Lichenoid <span class=\"term\" data-term-id=\"1015\">rashes<\/span> are rare skin rashes that can be induced by many environmental agents, medications, or industrial by-products such as inhaled particles. the <span class=\"term\" data-term-id=\"255\">eruption<\/span> from a lichenoid drug rash can sometimes be difficult to distinguish from <span class=\"term\" data-term-id=\"862\">idiopathic<\/span> lichen planus due to similarities in clinical appearance and <span class=\"term\" data-term-id=\"223\">pathology<\/span> seen on the skin <span class=\"term\" data-term-id=\"24\">biopsy<\/span>.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQuien-contrae-una-erupcion-de-drogas-liquenoides\"><\/span>Who gets a lichenoid drug rash?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Many medications have been reported in association with lichenoid drug eruptions, but often the time between the initiation of the medication and the appearance of the eruption (the <span class=\"term\" data-term-id=\"1040\">latent<\/span> period) can be long, more than a year in some cases. In general, the latency period is 2 to 3 months (although this can vary for different drugs) and has even been reported to develop after the drug has stopped. This can make it difficult to identify the culprit drug.<\/p>\n<p>Medications commonly reported to trigger a lichenoid drug rash include:<\/p>\n<ul>\n<li>Antihypertensive: ACE inhibitors, beta blockers, nifedipine, methyldopa<\/li>\n<li>Diuretics: hydrochlorothiazide, frusemide, spironolactone<\/li>\n<li>Non-steroidal anti-inflammatory drugs (<span class=\"term\" data-term-id=\"635\">NSAID<\/span>)<\/li>\n<li>Phenothiazine derivatives<\/li>\n<li>Anticonvulsants: carbamazepine, phenytoin.<\/li>\n<li>Medicines to treat tuberculosis.<\/li>\n<li>Antifungal drug - ketoconazole\n<\/li>\n<li>Chemotherapeutic agents: <a class=\"wpil_keyword_link\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/hydroxyurea\/\" title=\"hydroxyurea\"><a class=\"wpil_keyword_link\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/hydroxyurea\/\" title=\"hydroxyurea\">hydroxyurea<\/a><\/a>, 5-fluorouracil, imatinib\n<\/li>\n<li>\n<p>Antimalarial agents such as hydroxychloroquine.\n<\/li>\n<li>\n<p>Sulfa medications, including the hypoglycemic agents sulfonylurea, dapsone, mesalazine, sulfasalazine\n<\/li>\n<li>Metals - gold salts\n<\/li>\n<li>Others: allopurinol, iodides and radiocontrast media, interferon-a, omeprazole, penicillamine, tetracycline\n<\/li>\n<\/ul>\n<p>Other medications that have been reported in association with lichenoid drug eruptions include:<\/p>\n<ul>\n<li>\n<span class=\"term\" data-term-id=\"289\">Tumor<\/span> <span class=\"term\" data-term-id=\"403\">necrosis<\/span> antagonists of factors such as infliximab, etanercept, and adalimumab\n<\/li>\n<li>Imatinib Mesylate<span class=\"term\" data-term-id=\"624\">tyrosine kinase<\/span> inhibitor)<\/li>\n<li>Misoprostol (prostaglandin E1 agonist)<\/li>\n<li>Sildenafil citratus (Viagra \u2122)<\/li>\n<li>Vaccines (especially those of <a class=\"wpil_keyword_link\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/infeccion-de-herpes\/\" title=\"Herpes zoster\">Herpes zoster<\/a> and the flu).<\/li>\n<\/ul>\n<p>If a lichenoid rash has turned into a drug, it is quite possible that the same reaction will appear more quickly after exposure to another drug from the same family. Reported examples have included proton pump inhibitors (for dyspepsia) and HMG-CoA reductase inhibitors (for high <span class=\"term\" data-term-id=\"1507\">cholesterol<\/span>)<\/p>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-las-caracteristicas-clinicas-de-la-erupcion-de-un-medicamento-liquenoide\"><\/span>What are the clinical features of a lichenoid drug rash?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Lichenoid drug eruptions can be very similar to those of idiopathic lichen planus, although there may be features that can help distinguish them, which may include:<\/p>\n<ul>\n<li>Extensive skin rash distributed symmetrically on the trunk and extremities.<\/li>\n<li>Photodistribution: the rash is predominantly in areas exposed to the sun<\/li>\n<li>The rash may be <span class=\"term\" data-term-id=\"385\">scaly<\/span> resembling <span class=\"term\" data-term-id=\"491\">eczema<\/span> or psoriasis\n<\/li>\n<li>Wickham striae are generally absent<\/li>\n<li>Nail and <span class=\"term\" data-term-id=\"188\">mucous<\/span> membrane involvement (eg, mouth) is rare (oral lichen planus)<\/li>\n<li>More likely to mark <span class=\"term\" data-term-id=\"1521\">pigmentation<\/span> after the active rash has disappeared.<\/li>\n<\/ul>\n<section class=\"textBlock imageLinkBlockTitle\">\n<h5 class=\"colour--primary\"><span class=\"ez-toc-section\" id=\"Erupcion-de-drogas-liquenoides\"><\/span>Lichenoid drug rash<span class=\"ez-toc-section-end\"><\/span><\/h5>\n<\/section>\n<section class=\"imageLinkBlock\">\n<div class=\"flex\">\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='lichenoid-drug1__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-5721064-3176382' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/lichenoid-drug1__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-5721064.jpg'>\n<\/div>\n<p class=\"p-small\">Lichenoid drug rash<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='lichenoid-drug2__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-5586260-8222570' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/lichenoid-drug2__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-5586260.jpg'>\n<\/div>\n<p class=\"p-small\">Lichenoid drug rash<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='lichenoid-drug3__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-4938417-8606542' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/lichenoid-drug3__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-4938417.jpg'>\n<\/div>\n<p class=\"p-small\">Lichenoid drug rash<\/p>\n<\/p><\/div>\n<\/section>\n<div class=\"clearfix imageLinkBlock\"><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-se-diagnostica-la-erupcion-de-un-medicamento-liquenoide\"><\/span>How is a lichenoid drug rash diagnosed?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The diagnosis can be suspected from the unusual clinical features, and a skin biopsy is then taken. The pathological features of a lichenoid drug eruption may be difficult to distinguish from idiopathic lichen planus, but the type of eruption may be suggested by the types and <span class=\"term\" data-term-id=\"69\">distribution<\/span> of <span class=\"term\" data-term-id=\"490\">inflammatory<\/span> cells, as well as other changes.<\/p>\n<p>A detailed history of medications taken in the past year, including those taken only briefly (or even just once), can help identify the culprit.<\/p>\n<p>Sometimes <span class=\"term\" data-term-id=\"224\">patch<\/span> Testing with the drug can confirm identification, but false negatives are common.<\/p>\n<p>A &quot;challenge test&quot; involves deliberately re-administering the drug to the patient in the hope that the rash will reappear, but more quickly. Sometimes this happens unintentionally when another member of the same class of drugs is given to treat the original medical problem, or the same drug is given for a different problem.<\/p>\n<p>Discontinuation of the suspected drug with resolution of the rash is generally taken as confirmation of the diagnosis and drug trigger.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCual-es-el-tratamiento-para-la-erupcion-de-la-droga-liquenoide\"><\/span>What is the treatment for lichenoid drug rash?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The trigger medicine should be stopped and the rash should improve, although it may take weeks or months to clear up. Commonly flat <span class=\"term\" data-term-id=\"1520\">pigmented<\/span> Freckles persist and fade more slowly. Nail disease will take six months or longer to clear up, although gradually spreading improvement can be seen during this time.<\/p>\n<p>Sometimes the drug cannot be discontinued due to the significance of the underlying medical condition compared to the rash, e.g. Eg imatinib for <span class=\"term\" data-term-id=\"319\">chronic<\/span> <span class=\"term\" data-term-id=\"1896\">myeloid<\/span> <span class=\"term\" data-term-id=\"613\">leukemia<\/span> or gastrointestinal stromal tumor. The dose can be reduced or continued unchanged and the rash can be treated with <span class=\"term\" data-term-id=\"1330\">current<\/span> steroid <span class=\"term\" data-term-id=\"1121\">cream<\/span> or, if it is very extensive and severe, oral corticosteroids such as prednisone or prednisolone. Steroids can provide good relief or even resolution.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>Que es un liquenoide f\u00e1rmaco erupci\u00f3n? Liquenoide erupciones son erupciones cut\u00e1neas poco comunes que pueden ser inducidas por muchos agentes ambientales, medicamentos o subproductos industriales como part\u00edculas inhaladas. los erupci\u00f3n&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[],"class_list":["post-16648","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/16648","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=16648"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/16648\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=16648"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=16648"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=16648"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}