Header

UZH-Logo

Maintenance Infos

Lichenoid drug eruption following intravenous application of orally formulated diamorphine, a semisynthetic heroin


Kolm, Isabel; Eggmann, N; Kamarashev, J; Kerl, K; French, L E; Hofbauer, G F L (2013). Lichenoid drug eruption following intravenous application of orally formulated diamorphine, a semisynthetic heroin. Case Reports in Dermatology, 5(2):176-180.

Abstract

BACKGROUND: Lichen planus is a common skin disorder of unknown etiology. Most cases are idiopathic, but substances such as gold, antimalarials, penicillamine, thiazide diuretics, β-blockers, arsenic and nonsteroidal anti-inflammatory drugs have been implicated as trigger factors.
CASE PRESENTATION: We report the case of a lichenoid eruption in a male drug addict who administered oral heroin (diamorphine) intravenously. Diamorphine was stopped immediately. Following topical steroids, phototherapy and oral acitretin, the lesions gradually disappeared. A lymphocyte transformation test was negative for pure morphine and codeine.
DISCUSSION: A coincidental association between the intravenous application of orally formulated semisynthetic heroin and the lichenoid eruption cannot be completely ruled out. However, the diagnosis of a lichenoid drug eruption is favoured over idiopathic lichen planus because of the clear chronological correlation between drug use and appearance as well as drug withdrawal and disappearance of the skin lesions, and because of a flare-up following repeated intravenous application of diamorphine.

Abstract

BACKGROUND: Lichen planus is a common skin disorder of unknown etiology. Most cases are idiopathic, but substances such as gold, antimalarials, penicillamine, thiazide diuretics, β-blockers, arsenic and nonsteroidal anti-inflammatory drugs have been implicated as trigger factors.
CASE PRESENTATION: We report the case of a lichenoid eruption in a male drug addict who administered oral heroin (diamorphine) intravenously. Diamorphine was stopped immediately. Following topical steroids, phototherapy and oral acitretin, the lesions gradually disappeared. A lymphocyte transformation test was negative for pure morphine and codeine.
DISCUSSION: A coincidental association between the intravenous application of orally formulated semisynthetic heroin and the lichenoid eruption cannot be completely ruled out. However, the diagnosis of a lichenoid drug eruption is favoured over idiopathic lichen planus because of the clear chronological correlation between drug use and appearance as well as drug withdrawal and disappearance of the skin lesions, and because of a flare-up following repeated intravenous application of diamorphine.

Statistics

Citations

Altmetrics

Downloads

43 downloads since deposited on 07 Jan 2014
10 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Drug eruption, Diamorphine, Synthetic heroin, Lichen planus
Language:English
Date:2013
Deposited On:07 Jan 2014 15:59
Last Modified:25 Aug 2017 15:27
Publisher:Karger
ISSN:1662-6567
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1159/000353305
PubMed ID:23874294

Download

Download PDF  'Lichenoid drug eruption following intravenous application of orally formulated diamorphine, a semisynthetic heroin'.
Preview
Content: Published Version
Language: English
Filetype: PDF
Size: 1MB
View at publisher
Licence: Creative Commons: Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY-NC-ND 3.0)