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[Cutaneous adverse
effects during selective serotonin reuptake inhibitors therapy: 2
cases]
[Article in French]
Richard MA,
Fiszenson F, Jreissati M, Jean Pastor MJ, Grob JJ.
Service de
Dermatologie, Hopital Sainte-Marguerite, Marseille.
mrichard@mail.ap-hm.fr
BACKGROUND: Selective serotonin reuptake
inhibitors are widely used in the treatment of depressive and
obsessive-compulsive disorders because of their low-frequency adverse
effects. We report two cases of cutaneous adverse effects during
selective serotonin reuptake inhibitors therapy.CASE REPORTS: A man who
complained of chronic anal idiopathic pruritus was treated with
citalopram (Seropram(R)) 10 mg b.i.d. Six days after the beginning of
the antidepressive treatment, he developed an extensive papular and
purpuric erythema with keratinocytes necrosis and dermal
leucocytoclastic vasculitis. Cutaneous lesions remained for several
weeks, as the half-life of citalopram is very long (33 to 36 hours) but
did not relapse. A women developed painful papular and purpuric erythema
mainly located in sun-exposed sites, during therapy with paroxetine
(Deroxat(R)) 20 mg b.i.d., which had been introduced one month before to
treat depression. Cutaneous lesions healed spontaneously in 2 weeks
after the discontinuation of paroxetine and with sun avoidance and
didn't relapse.DISCUSSION: Adverse cutaneous effects of selective
serotonin reuptake inhibitors are rare but the knowledge of these
reactions is important because toxic epidermal necrolysis and
Stevens-Johnson syndrome had been reported during fluoxetine (Prozac(R))
and fluvoxamine (Floxyfral(R)) treatment. Different serotonin uptake
blockers could be involved in the same allergic reaction, suggesting
cross reactivity, although these drugs have different chemistry
structures. It is advisable to substitute after an adverse effect a
medication from one of the other classes of
antidepressants.
Publication Types:
PMID: 11460042 [PubMed - indexed for
MEDLINE]
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