Dexlansoprazole-Induced Subacute Cutaneous Lupus Erythematosus (SCLE): 2166
Abstract
Drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) was first described in 1985 in patients taking hydrochlorothiazide. Since then, there have been many reports of DI-SCLE. One of the newer drug classes reported to be associated with DI-SCLE is proton pump inhibitors (PPI). In 2014, Sandholdt et al reported 24 episodes of PPI-induced SCLE in a case series. We present another case of SCLE induced by a PPI that is the first case of Dexlansoprazole-induced SCLE. Our patient is a 52 year old Caucasian male with a history of long standing reflux unresponsive to Nexium and Prilosec. He took Dexlansoprazole 60mg daily which worked very well for his reflux symptoms. He did not start any other new medications. A week later, he developed a rash which started with one lesion on the left upper arm that progressed to multiple non-pruritic spots on the trunk and arms and later to his face, neck, chest, back, abdomen, shoulders and dorsal forearms. The rash consisted of scattered round erythematous plaques, some of which were annular with central peeling/necrotic areas, and a trailing scale on many lesions. Otherwise he was asymptomatic with no systemic symptoms. A punch biopsy showed vacuolar interface dermatitis, consistent with a diagnosis of SCLE. His blood work revealed Anti-SS-A/Ro and Anti-SS-B/La positivity, negative ds DNA antibodies, normal C3 and C4 complement levels and his ANA was only 1:80 positive. Dexlansoprazole was stopped and he required Prednisone, Plaquenil…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 1,985 participants or records.
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