Drug-Induced Neutropenia During Treatment of Non-Neoplastic Dermatologic Diseases: A Review
Journal
Clinical drug investigation
Journal Volume
40
Journal Issue
10
Pages
915
Date Issued
2020-10
Author(s)
Hsieh, Chang-Yu
Abstract
Idiosyncratic drug-induced neutropenia (DIN) is a rare, potentially fatal adverse reaction. A literature search was performed on Pubmed and Embase, targeting articles indicating neutropenia as a complication during the treatment of non-neoplastic dermatological disorders. In 66 identified articles, the common incriminated drugs included conventional oral immunomodulators, topical cytotoxic agents, antibacterials, antifungals, biologics and targeted synthetic disease-modifying antirheumatic drugs, non-steroidal anti-inflammatory drugs, and retinoids, with dapsone being reported most often. The duration of drug exposure before the diagnosis of neutropenia varied, but mostly ranged from days to weeks. The majority of patients recovered after drug discontinuation and supportive management including antibiotics and granulocyte colony-stimulating factor, but fatal cases were reported. The proposed pathogenesis of DIN consists of direct drug toxicity and immune-mediated reaction. Certain genetic variants, individual variability in enzyme efficiency, and concomitant use of other drugs may increase the risk of DIN. Being familiar with the most commonly implicated agents and risk factors helps early identification and prompt management of this potentially fatal complication.
SDGs
Other Subjects
azathioprine; colchicine; cytotoxic agent; dapsone; etretin; fluorouracil; granulocyte colony stimulating factor; hydroxychloroquine; isotretinoin; Janus kinase inhibitor; lenalidomide; methotrexate; minocycline; podophyllin; rituximab; salazosulfapyridine; sulfadiazine silver; terbinafine; tumor necrosis factor inhibitor; antineoplastic agent; granulocyte colony stimulating factor; bibliographic database; drug exposure; drug induced disease; genetic variability; human; neutropenia; priority journal; Review; risk factor; treatment duration; neutropenia; Antineoplastic Agents; Granulocyte Colony-Stimulating Factor; Humans; Neutropenia
Publisher
ADIS INT LTD
Type
journal article