Acitretin-induced subungual hemorrhage
Date
2007-04-30
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Wiley
Abstract
A 20-year-old woman with a 2-year history of histologically confirmed palmoplantar keratoderma due to psoriasis, resistant to several topical agents, was admitted to the Department of Dermatology, Uludag University, Bursa, Turkey. Therapy with oral acitretin (0.5mg/kg/day, 35mg/day) was initiated. A month after starting acitretin treatment, she noted slight reddening of the second left fingernail. Clinical examination revealed red-brown discoloration of the second fingernail associated with subungual hemorrhage involving the proximal nail bed (lunula region) (Fig. 1). The nail change was asymptomatic. The patient complained only of discoloration underneath the nail plate. No abnormalities were detected on the skin, mucous membranes, or toenails/ other fingernails. The patient denied exposure to microtrauma or any other drugs. The erythrocyte sedimentation rate, full blood cell count, electrolytes, renal and hepatic tests, and serum lipids were normal. Coagulation tests, including blood clotting time, international normalized ratio, activated partial thromboplastin time, thrombin time, platelet number, and function tests, were within normal levels. Treatment with acitretin was discontinued, and the nail change resolved completely after 3 weeks. A similar episode of subungual hemorrhage recurred, however, within 48 h after re-challenge with a lower dose of acitretin (25 mg/day). The drug was definitively stopped and the eruption faded again within a week. An objective causality assessment suggests that subungual hemorrhage was probably related to acitretin in this patient.
Description
Bu çalışma, 12-16 Ekim 2005 tarihlerinde Londra[Birleşik Krallık]'da düzenlenen 14. Congress of The European Academy of Dermatology and Venereology'de poster olarak sunulmuştur.
Keywords
Dermatology, Psoriasis, Etretinatem, Multicenter, Secondary
Citation
Aydoğan, K. vd. (2007). "Acitretin-induced subungual hemorrhage". International Journal of Dermatology, 46(5), 494-495.