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Captopril‐Induced Skin Eruptions
Author(s) -
LUDERER JOHN R.,
LOOKINGBILL DONALD P.,
SCHNECK DENNIS W.,
DEMERS LAWRENCE M.,
COHEN CYNTHIA,
HAYES ARTHUR H.
Publication year - 1982
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1982.tb02156.x
Subject(s) - medicine , captopril , leukocytosis , gastroenterology , rash , erythrocyte sedimentation rate , concomitant , anemia , eosinophilia , pathology , blood pressure
Seven of 23 hypertensive patients treated with captopril (SQ 14,225), an orally active converting enzyme inhibitor, developed a pruritic, erythematous, macular, and papular eruption of the trunk, face, and proximal extremities. The eruption appeared one to 31 weeks after initiation of captopril therapy and was associated with diarrhea (three patients), fever (two patients), and generalized arthralgias (one patient). Six patients had an increased percentage of band cells (5 to 34 per cent) on peripheral smear without an associated leukocytosis. In one patient, the skin rash was associated with a peripheral eosinophilia (20 per cent), Coombs‐positive hemolytic anemia, and acute renal failure with eosinophiluria. There were no changes in BUN, creatinine, or urinalyses in the remaining patients. Four patients showed a transient rise in plasma PGE without concomitant changes in plasma PFG 2α or 6‐keto PGF 1α , and three patients had slight elevations in the erythrocyte sedimentation rate. Skin biopsies revealed a perivascular and perifollicular lymphocytic and histiocytic infiltrate with negative immunofluorescence to IgG, IgM, IgA, and β 1 C. The skin eruption and associated symptoms resolved in all patients, even though captopril administration was continued in six of the seven patients.