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Lichen Planus-Like Drug Eruptions Due to β-Blockers

A Case Report and Literature Review

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Abstract

Lichen planus-like drug eruptions (LDE) can appear similar or identical to idiopathic lichen planus. We present a 45-year-old man with a widespread, violaceous, papular, generalized exanthema with histologic features of a lichenoid reaction, which subsequently resolved with the cessation of labetatol. We found 29 cases of previously reported β-adrenoceptor antagonist (β-blocker)-associated LDE. This is a relatively rare complication that may present as classic lichenoid papules indistinguishable from lichen planus and has a predilection for the limbs, chest, back, and oral mucosa. Histologically, there is a lichenoid infiltrate often with eosinophils. LDE may be due to drug cross-reactivity or as a result of a suppressed skin adrenergic system. Multiple potential medications in case studies and the inability to differentiate LDE from idiopathic lichen planus in cross-sectional association studies make any conclusive analysis difficult.

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Acknowledgments

No sources of funding were received to prepare this case report. The authors have no conflicts of interest that are directly relevant to the content of this case report.

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Authors and Affiliations

  1. Department of Dermatology, Westmead Hospital, Westmead, New South Wales, NSW 2145, Australia

    Chris Fessa

  2. The Skin and Cancer Foundation Australia, Darlinghurst, New South Wales, Australia

    Penny Lim & Steve Kossard

  3. The Skin and Cancer Foundation Australia, Westmead, New South Wales, Australia

    Shawn Richards & Pablo Fernandez Peñas

  4. Western Clinical School, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia

    Pablo Fernandez Peñas

Authors
  1. Chris Fessa
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  2. Penny Lim
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  3. Steve Kossard
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  4. Shawn Richards
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  5. Pablo Fernandez Peñas
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Correspondence to Chris Fessa.

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Fessa, C., Lim, P., Kossard, S. et al. Lichen Planus-Like Drug Eruptions Due to β-Blockers. Am J Clin Dermatol 13, 417–421 (2012). https://doi.org/10.2165/11634590-000000000-00000

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