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Adverse Cutaneous Reactions to Hydroxychloroquine Are More Common in Patients With Dermatomyositis Than in Patients With Cutaneous Lupus Erythematosus
Michelle T. Pelle, MD;
Jeffrey P. Callen, MD
Arch Dermatol. 2002;138:1231-1233.
Background Hydroxychloroquine sulfate and other antimalarial drugs have been used
successfully as adjunctive therapy for patients with cutaneous lesions of
dermatomyositis over the past 20 years. An increased incidence of cutaneous
reactions to hydroxychloroquine has been postulated to occur in patients with
dermatomyositis.
Objective To determine if adverse cutaneous eruptions due to hydroxychloroquine
are more common in patients with dermatomyositis than in those with cutaneous
lupus erythematosus.
Design Retrospective, age-, sex-, and race-matched case-control study.
Setting University-affiliated practice.
Patients The study comprised 42 patients with dermatomyositis (39 adults) and
39 age-, sex-, and race-matched adult patients with lupus erythematosus.
Main Outcome Measures Presence or absence of documented drug eruption due to hydroxychloroquine
exposure.
Results Of 39 patients, 12 (31%) with dermatomyositis developed a cutaneous
reaction to hydroxychloroquine. Among age-, sex-, and race-matched patients
with cutaneous lupus erythematosus, only 1 developed a cutaneous reaction
to hydroxychloroquine. None of the reactions observed in our patients resulted
in serious morbidity or mortality. Additionally, 4 patients with dermatomyositis
who reacted to hydroxychloroquine were treated with oral chloroquine phosphate,
2 of whom also reacted to chloroquine phosphate.
Conclusions When contemplating antimalarial therapy for dermatomyositis, both the
physician and the patient should recognize that non–life-threatening
cutaneous reactions may occur in approximately one third of patients and that
perhaps one half of those who react to hydroxychloroquine will also react
to chloroquine.
From the Department of Dermatology, University of Pennsylvania School
of Medicine, Philadelphia (Dr Pelle); and the Department of Medicine, Division
of Dermatology, University of Louisville School of Medicine, Louisville, Ky
(Dr Callen).
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ABSTRACT
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