Cutaneous drug reactions to antihypertensive agents: a report from a single center in Pakistan

Background: This study was conducted because up to now, the investigations performed on cutaneous manifestations of antihypertensive agents’ reactions, especially in Pakistan, are negligible even though these drugs are taken by a large number of people. The aim of this study was to determine the cutaneous manifestations of different antihypertensive agents in terms of dosage and duration. Method: The study was carried out at the Departments of Dermatology and Cardiology, Civil Hospital, Karachi. The study was carried out from June 2007 to December 2007. The inclusion criteria included all patients taking a single antihypertensive agent with cutaneous manifestations. Patients taking antihypertensive drugs but suffering from some other dermatological diseases and those taking more than one drug were excluded. After informed consent, history, specifically regarding the type of drug dosage and duration of drug intake was taken. Specific investigations such as biopsy were done if indicated. Result: Out of 100 patients, 37 were male and 63 were female. Most of the patients were in the age group 46–60 years. The majority (97%) of patients experienced the onset of lesions between 4–8 weeks of therapy and only 2% had lesions within 4 weeks. Moderate lesions were markedly more common and were found in 65% followed by mild lesions in 26%, severe in 6%, and lethal in 3% of the patients. The most common lesions were pruritis and eczema, followed by flushing, lichenoid eruptions, oral ulcers, purpuras, psoriasis, exanthematous reactions, urticaria,gingival hyperplasia, lichen planus, morbilliform rashes, oral lichen planus and butterfly rash. Conclusion: No relation was noted between a drug dose and the severity of skin lesions. Most patients started having skin lesions 4 to 8 weeks after therapy.