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      About Skin Pharmacology and Physiology: 2.8 Impact Factor I 5.2 CiteScore I 0.623 Scimago Journal & Country Rank (SJR)

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      Minocycline-Induced DRESS: Evidence for Accumulation of the Culprit Drug

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          Abstract

          Background: Minocycline-induced drug rash with eosinophilia and systemic symptoms (DRESS) may have a prolonged course, especially in African and African-American patients. Objectives: To determine if a prolonged course of minocycline-induced DRESS was associated with an accumulation of the culprit drug. Patients and Methods: We determined plasma and skin levels of minocycline in patients with minocycline-induced DRESS. We investigated the genetic polymorphisms of enzymes potentially involved in the detoxification of the drug, glutathione S-transferases and UDP-glucuronosyltransferases. Results and Conclusions: We demonstrated the persistence of minocycline in the plasma and/or in the skin of 7 out of 9 patients with skin phototypes V–VI. As pigmented skin contains more melanin, this could promote the formation of a melanin-minocycline complex, which could explain the severe and prolonged DRESS which may occur in this subgroup of patients.

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          Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS).

          H. Bocquet, M Bagot, J C Roujeau (1996)
          Since the first description by Saltzstein in 1959, the denomination of drug-induced pseudolymphoma was used to describe two cutaneous adverse drug reactions with a histological picture mimicking malignant lymphoma. On the basis of clinical presentation, this term includes two different patterns: (1) hypersensitivity syndrome which begins acutely in the first 2 months after the initiation of the drug and associates fever, a severe skin disease with characteristic infiltrated papules and facial edema or an exfoliative dermatitis, lymphadenopathy, hematologic abnormalities (hypereosinophilia, atypical lymphocytes) and organ involvement such as hepatitis, carditis, interstitial nephritis, or interstitial pneumonitis. The cutaneous histological pattern shows a lymphocytic infiltrate, sometimes mimicking a cutaneous lymphoma, and the mortality rate is about 10%. When organ involvement exists, corticosteroids are often prescribed with dramatic improvement. Relapses may occur. (2) drug-induced pseudolymphoma which has a more insidious beginning with nodules and infiltrated plaques appearing several weeks after the beginning of the drug without constitutional symptoms. A pseudolymphoma pattern is seen on cutaneous histological slides. Complete improvement is usual after drug withdrawal, but a delayed lymphoma is possible. To decrease the ambiguity of the denomination of hypersensitivity syndrome, we propose the term of DRESS (Drug Rash with Eosinophilia and Systemic Symptoms).
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            The validity and practicality of sun-reactive skin types I through VI

            T Fitzpatrick (1988)
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              Clinical pharmacokinetics of doxycycline and minocycline.

              S Saivin, G Houin (1988)
              Doxycycline and minocycline are second-generation tetracyclines. They are readily absorbed, distributed throughout the organism as a function of their lipophilicity and eliminated in both the urine and the faeces. The influence of age, renal disease, malnutrition and hyperlipidaemia is reviewed, together with the main pharmacokinetic interactions.
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                Author and article information

                Journal
                Journal ID (publisher-id): DRM
                Journal ID (nlm-ta): Dermatology
                Journal ID (doi): 10.1159/issn.1018-8665
                Title: Dermatology
                Publisher: S. Karger AG
                ISSN (Print): 1018-8665
                ISSN (Electronic): 1421-9832
                Publication date Subscription-year: 2008
                Publication date (Print): March 2008
                Publication date (Electronic): 09 January 2008
                Volume: 216
                Issue: 3
                Pages: 200-204
                Affiliations
                Departments of aDermatology and bPathology, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; cDepartment of Dermatology, Hôpital Bichat, dDepartment of Biochemistry, European Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, and eINSERM UMRS 490, Faculté de Médecine, Université Paris-Descartes, Paris, France
                Article
                Publisher ID: 112926 Other ID: Dermatology 2008;216:200–204
                DOI: 10.1159/000112926
                PubMed ID: 18182810
                SO-VID: f4de46e2-86bc-4500-b35d-598d046377ce
                Copyright © © 2008 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 19 March 2007
                Date accepted : 07 August 2007
                Page count
                Figures: 1, Tables: 2, References: 25, Pages: 5
                Categories
                Subject: Clinical and Laboratory Investigations

                ScienceOpen disciplines: Oncology & Radiotherapy,Pathology,Surgery,Dermatology,Pharmacology & Pharmaceutical medicine
                Keywords: Glutathione S-transferase,Minocycline,Melanin,Drug rash with eosinophilia and systemic symptoms (DRESS),African-American patients
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy, Pathology, Surgery, Dermatology, Pharmacology & Pharmaceutical medicine
                Keywords: Glutathione S-transferase, Minocycline, Melanin, Drug rash with eosinophilia and systemic symptoms (DRESS), African-American patients

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