Hydroxychloroquine effects on psoriasis: a systematic review and a cautionary note for COVID-19 treatment

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Abstract:

Background

While evidence suggests that hydroxychloroquine (HCQ) may decrease the viral load in patients with a COVID-19 infection, a number of case reports indicate adverse dermatologic effects of this potential treatment.

Objective

To conduct a systematic review of previously reported cases of psoriasis onset, exacerbation, or relapse after HCQ treatment.

Methods

A comprehensive EMBASE and MEDLINE search of original studies examining adverse effects of HCQ treatment related to psoriasis was conducted. Participant demographics, and details of HCQ administration and psoriasis diagnosis were extracted from 15 articles representing 18 patients.

Results

Females accounted for a significantly larger number of psoriatic cases compared to males and unreported sex (n=14, 77.8% vs. n=2, 11.1% vs n=2, 11.1% respectively). Additionally, 50% (n=9) of the cases did not have a history of psoriasis prior to taking HCQ. Of the 18 patients, 50.0% (n=9) experienced de novo psoriasis, 27.8% (n=5) experienced exacerbation of psoriatic symptoms and 22.2% (n=4) had a relapse of psoriasis after HCQ administration.

Conclusions

HCQ treatment may result in induction, exacerbation, or relapse of psoriasis. Monitoring for adverse effects of HCQ treatment is necessary, and clinical trials are essential in characterizing the safety profile of HCQ use in patients with a COVID-19 infection.

Abstract

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Author and article information

Contributors

Jensen Yeung

Journal

Journal ID (nlm-ta): J Am Acad Dermatol

Journal ID (iso-abbrev): J. Am. Acad. Dermatol

Title: Journal of the American Academy of Dermatology

Publisher: Published by Elsevier on behalf of the American Academy of Dermatology, Inc.

ISSN (Print): 0190-9622

ISSN (Electronic): 1097-6787

Publication date PMC-release: 19 May 2020

Publication date (Electronic): 19 May 2020

Affiliations

[1 ]Faculty of Medicine, University of Toronto, Canada

[2 ]Department of Dermatology, University of Toronto, Toronto, Canada

Author notes

[∗ ] Corresponding author: Jensen Yeung, Women’s College Hospital, Division of Dermatology. 76 Greenville St, 5 ^th floor, Toronto, ON M5S 1B2, Canada. jensen.yeung@ 123456utoronto.ca

Article

Publisher ID: S0190-9622(20)30942-7

DOI: 10.1016/j.jaad.2020.05.074

PMC ID: 7235574

PubMed ID: 32442699

SO-VID: 8b7a00fa-c108-4561-a169-1aedea9528da

License:

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

History

Date received : 3 May 2020

Date revision received : 8 May 2020

Date accepted : 14 May 2020

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