Abstract
Angiotensin-converting enzyme inhibitors (ACEIs) can be classified into two sub groups according to their chemical structure: the one containing a thiol (or sulfhydryl [SH]) group such as captopril and zofenopril, and the other lacking a thiol group such as enalapril, ramipril, cilazapril, fosinopril, quinapril, trandolapril, lisinopril, perindopril, moexipril, benazepril, imidapril, delapril, alecepril, and spirapril.
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Steckelings UM, Artuc M, Wollschlager T, Wiehstutz S, Henz BM. Angiotensin-converting enzyme inhibitors as inducers of adverse cutaneous reactions. Acta Derm Venereol. 2001;81:321–5.
Kyrmizakis DE, Papadakis CE, Liolios AD, Karatzanis AD, Malandrakis S, Skoulakis CE, et al. Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists. Arch Otolaryngol Head Neck Surg. 2004;130:1416–9.
Wolf R, Tamir A, Brenner S. Psoriasis related to angiotensin-converting enzyme inhibitors. Dermatologica. 1990;181:51–3.
Wilkin JK, Hammond JJ, Kirkendall WM. The captopril-induced eruption. A possible mechanism: cutaneous kinin potentiation. Arch Dermatol. 1980;116:902–5.
Winters ME, Rosenbaum S, Vilke GM, Almazroua FY. Emergency department management of patients with ACE-inhibitor angioedema. J Emerg Med. 2013;45:775–80.
Rasmussen ER, Mey K, Bygum A. Angiotensin-converting Enzyme Inhibitor-induced Angioedema – A Dangerous New Epidemic. Acta Derm Venereol. 2014;94:260–4. doi:10.2340/00015555-1760.
Cohen EG, Soliman AM. Changing trends in angioedema. Ann Otol Rhinol Laryngol. 2001;110:701–6.
Kostis JB, Kim HJ, Rusnak J, Casale T, Kaplan A, Corren J, Levy E. Incidence and characteristics of angioedema associated with enalapril. Arch Intern Med. 2005;165:1637–42.
Straka B, Nian H, Sloan C, Byrd JB, Woodard-Grice A, Yu C, Stone E, et al. Pollen count and presentation of Angiotensin-converting enzyme inhibitor-associated angioedema. J Allergy Clin Immunol Pract. 2013;1:468–73.
Pillans PI, Coulter DM, Black P. Angiooedema and urticaria with angiotensin converting enzyme inhibitors. Eur J Clin Pharmacol. 1996;51:123–6.
Hedner T, Samuelsson O, Lunde H, Lindholm L, Andren L, Wiholm BE. Angio-oedema in relation to treatment with angiotensin converting enzyme inhibitors. BMJ. 1992;304:941–6.
Chalmers D, Whitehead A, Lawson DH. Postmarketing surveillance of captopril for hypertension. Br J Clin Pharmacol. 1992;34:215–23.
Lee A, Thomson J. Drug-induced skin reactions. In: Adverse drug reactions. 2nd ed. London: Pharmaceutical Press; 2006. p. 125–56.
Vleeming W, van Amsterdam JG, Stricker BH, de Wildt DJ. ACE inhibitor-induced angioedema. Incidence, prevention and management. Drug Saf. 1998;18:171–88.
Chu TJ, Chow N. Adverse effects of ACE inhibitors. Ann Intern Med. 1993;118:314.
Garcia-Pavia P, Tomas JM, Alonso-Pulpón L. Late-onset angioedema due to an angiotensin-converting enzyme inhibitor. Can J Cardiol. 2007;23:315–6.
Norman JL, Holmes WL, Bell WA, Finks SW. Life-threatening ACE inhibitor-induced angioedema after eleven years on lisinopril. J Pharm Pract. 2013;26:382–8.
Amey G, Waidyasekara P, Kollengode R. Delayed presentation of ACE inhibitor-induced angio-oedema. BMJ Case Rep. 2013;2013. doi: 10.1136/bcr-2013-010453.
Howarth D. ACE inhibitor angioedema – a very late presentation. Aust Fam Physician. 2013;42:860–2.
Lewis LM. Angioedema: etiology, pathophysiology, current and emerging therapies. J Emerg Med. 2013;45:789–96.
Haymore BR, Yoon J, Mikita CP, Klote MM, DeZee KJ. Risk of angioedema with angiotensin receptor blockers in patients with prior angioedema associated with angiotensin-converting enzyme inhibitors: a meta-analysis. Ann Allergy Asthma Immunol. 2008;101:495–9.
Wolf R, Tamir A, Brenner S. Drug-induced versus drug-triggered pemphigus. Dermatologica. 1991;182:207–10.
Ong CS, Cook N, Lee S. Drug-related pemphigus and angiotensin converting enzyme inhibitors. Australas J Dermatol. 2000;41:242–6.
Baričević M, Mravak Stipetić M, Situm M, Marinović B, Seiwerth S, Baričević D, et al. Oral bullous eruption after taking lisinopril–case report and literature review. Wien Klin Wochenschr. 2013;125:408–11. doi:10.1007/s00508-013-0382-7.
Al-Niaimi F. Drug eruptions in dermatology. Expert Rev Dermatol. 2011;6:273–86.
Ruocco V, de Angelis E, Lombardi ML, Pisani M. In vitro acantholysis by captopril and thiopronine. Dermatologica. 1988;176:115–23.
Butt A, Burge SM. Pemphigus vulgaris induced by captopril. Br J Dermatol. 1995;132:315–6.
Thami GP, Kaur S, Kanwar AJ. Severe childhood pemphigus vulgaris aggravated by enalapril. Dermatology. 2001;202:341.
Parodi A, Cozzani E, Milesi G, Drosera M, Rebora A. Fosinopril as a possible pemphigus-inducing drug. Dermatology. 2002;204:139–41.
Shelton RM. Pemphigus foliaceus associated with enalapril. J Am Acad Dermatol. 1991;24:503–4.
Vignes S, Paul C, Flageul B, Dubertret L. Ramipril-induced superficial pemphigus. Br J Dermatol. 1996;135:657–8.
Buzon E, Perez-Bernal AM, de la Pena F, Rios JJ, Camacho F. Pemphigus foliaceus associated with cilazapril. Acta Derm Venereol. 1998;78:227.
Patterson CR, Davies MG. Pemphigus foliaceus: an adverse reaction to lisinopril. J Dermatolog Treat. 2004;15:60–2.
Pinto GM, Lamarao P, Vale T. Captopril-induced pemphigus vegetans with Charcot-Leyden crystals. J Am Acad Dermatol. 1992;27:281–4.
Bastiaens MT, Zwan NV, Verschueren GL, Stoof TJ, Nieboer C. Three cases of pemphigus vegetans: induction by enalapril–association with internal malignancy. Int J Dermatol. 1994;33:168–71.
Adriano AR, Gomes Neto A, Hamester GR, Nunes DH, Di Giunta G. Pemphigus vegetans induced by use of enalapril. An Bras Dermatol. 2011;86:1197–200.
Ruocco V, Satriano RA, Guerrera V. “Two-step” pemphigus induction by ACE-inhibitors. Int J Dermatol. 1992;31:33–6.
Kaplan RP, Potter TS, Fox JN. Drug-induced pemphigus related to angiotensin-converting enzyme inhibitors. J Am Acad Dermatol. 1992;26:364–6.
Femiano F, Scully C, Gombos F. Linear IgA dermatosis induced by a new angiotensin-converting enzyme inhibitor. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:169–73.
Friedman IS, Rudikoff D, Phelps RG, Sapadin AN. Captopril-triggered linear IgA bullous dermatosis. Int J Dermatol. 1998;37:608–12.
Flageul B, Foldes C, Wallach D, Vignon-Pennamen MD, Cottenot F. Captopril-induced lichen planus pemphigoides with pemphigus-like features. A case report. Dermatologica. 1986;173:248–55.
Ben Salem C, Chenguel L, Ghariani N, Denguezli M, Hmouda H, Bouraoui K. Captopril-induced lichen planus pemphigoides. Pharmacoepidemiol Drug Saf. 2008;17:722–4.
Ogg GS, Bhogal BS, Hashimoto T, Coleman R, Barker JN. Ramipril-associated lichen planus pemphigoides. Br J Dermatol. 1997;136:412–4.
Zhu YI, Fitzpatrick JE, Kornfeld BW. Lichen planus pemphigoides associated with ramipril. Int J Dermatol. 2006;45:1453–5.
Mallet L, Cooper JW, Thomas J. Bullous pemphigoid associated with captopril. DICP. 1989;23:63.
Fitzgerald DA. Subepidermal bullous eruption induced by captopril. Clin Exp Dermatol. 1993;18:196–7.
Smith EP, Taylor TB, Meyer LJ, Zone JJ. Antigen identification in drug-induced bullous pemphigoid. J Am Acad Dermatol. 1993;29(5 Pt 2):879–82.
Kalińska-Bienias A, Rogoziński TT, Woźniak K, Kowalewski C. Can pemphigoid be provoked by lisinopril? Br J Dermatol. 2006;155:854–5.
Wong SS, Long CC, Holt PJ. Lichenoid eruption induced by low dose captopril. Acta Derm Venereol. 1992;72:358–9.
Revenga Arranz F, Gonzalo Garijo MA. Lichenioid reaction induced by captopril. Rev Clin Esp. 1996;196:412.
Cox NH, Tapson JS, Farr PM. Lichen planus associated with captopril: a further disorder demonstrating the ‘tin-tack’ sign. Br J Dermatol. 1989;120:319–21.
Rotstein E, Rotstein H. Drug eruptions with lichenoid histology produced by captopril. Australas J Dermatol. 1989;30:9–14.
Reinhardt LA, Wilkin JK, Kirkendall WM. Lichenoid eruption produced by captopril. Cutis. 1983;31:98–9.
Bravard P, Barbet M, Eich D, Weber M, Daniel F, Lauret P. Captopril induced lichenoid eruption. Ann Dermatol Venereol. 1983;110:433–8.
Wolf R, Tamir A, Srebrnik A, Brenner S. Lichenoid eruption and alopecia associated with captopril treatment. J Dermatolog Treat. 1990;1:155–7.
Ruiz Villaverde R, Blasco Melguizo J, Linares Solano J, Serrano Ortega S. Lichen planus-like eruption due to enalapril. J Eur Acad Dermatol Venereol. 2003;17:612–4.
Roten SV, Mainetti C, Donath R, Saurat JH. Enalapril-induced lichen planus-like eruption. J Am Acad Dermatol. 1995;32:293–5.
Kanwar AJ, Dhar S, Ghosh S. Photosensitive lichenoid eruption due to enalapril. Dermatology. 1993;187:80.
Shackelton JB, English 3rd JC. Acute-onset reticulated white lip. JAMA. 2011;306:2267–8.
Furness PN, Goodfield MJ, MacLennan KA, Stevens A, Millard LG. Severe cutaneous reactions to captopril and enalapril; histological study and comparison with early mycosis fungoides. J Clin Pathol. 1986;39:902–7.
Mutasim DF. Lymphomatoid drug eruption mimicking digitate dermatosis: cross reactivity between two drugs that suppress angiotensin II function. Am J Dermatopathol. 2003;25:331–4.
Carroll J, Thaler M, Grossman E, Alder A, Trau H, Rosenthal T. Generalized pustular eruption associated with converting enzyme inhibitor therapy. Cutis. 1995;56:276–8.
Wolf R, Dorfman B, Krakowski A. Psoriasiform eruption induced by captopril and chlorthalidone. Cutis. 1987;40:162–4.
Coulter DM, Pillans PI. Angiotensin-converting enzyme inhibitors and psoriasis. N Z Med J. 1993;106:392–3.
Gilleaudeau P, Vallat VP, Carter DM, Gottlieb AB. Angiotensin-converting enzyme inhibitors as possible exacerbating drugs in psoriasis. J Am Acad Dermatol. 1993;28:490–2.
Antonov D, Grozdev I, Pehlivanov G, Tsankov N. Psoriatic erythroderma associated with enalapril. Skinmed. 2006;5:90–2.
Vena GA, Cassano N, Coco V, De Simone C. Eczematous reactions due to angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Immunopharmacol Immunotoxicol. 2013;35:447–50.
Eriksen JG, Christiansen JJ, Asmussen I. Postulosis palmoplantaris caused by angiotensin-converting enzyme inhibitors. Ugeskr Laeger. 1995;157:3335–6.
Thakor P, Padmanabhan M, Johnson A, Pararajasingam T, Thakor S, Jorgensen W. Ramipril-induced generalized pustular psoriasis: case report and literature review. Am J Ther. 2010;17:92–5.
Ikai K. Exacerbation and induction of psoriasis by angiotensin-converting enzyme inhibitors. J Am Acad Dermatol. 1995;32:819.
Atzori L, Pinna AL, Ferreli C, Aste N. Pityriasis rosea-like adverse reaction: review of the literature and experience of an Italian drug-surveillance center. Dermatol Online J. 2006;12:1.
Ghersetich I, Rindi L, Teofoli P, Tsampau D, Palleschi GM, Lotti T. Pityriasis rosea-like skin eruptions caused by captopril. G Ital Dermatol Venereol. 1990;125:457–9.
Wilkin JK, Kirkendall WM. Pityriasis rosea-like rash from captopril. Arch Dermatol. 1982;118:186–7.
Atzori L, Ferreli C, Pinna AL, Aste N. ‘Pityriasis rosea-like’ adverse reaction to lisinopril. J Eur Acad Dermatol Venereol. 2004;18:743–5.
Puppin Jr D, Rybojad M, de la Chapelle C, Morel P. Kaposi’s sarcoma associated with captopril. Lancet. 1990;336:1251–2.
Larbre JP, Nicolas JF, Collet P, Larbre B, Llorca G. Kaposi’s sarcoma in a patient with rheumatoid arthritis possible responsibility of captopril in the development of lesions. J Rheumatol. 1991;18:476–7.
Bilen N, Bayramgurler D, Aydeniz B, Apaydin R, Ozkara SK. Possible causal role of lisinopril in a case of Kaposi’s sarcoma. Br J Dermatol. 2002;147:1042–4.
Dervis E, Demirkesen C. Kaposi’s sarcoma in a patient with psoriasis vulgaris. Acta Dermatovenerol Alp Panonica Adriat. 2010;19:31–4.
Di Carlo A. Lisinopril and Kaposi’s sarcoma. Br J Dermatol. 2004;150:158–9.
Vogt B, Frey FJ. Inhibition of angiogenesis in Kaposi’s sarcoma by captopril. Lancet. 1997;349:1148.
Ratliff 3rd NB. Captopril induced lupus. J Rheumatol. 2002;29:1807–8.
Patri P, Nigro A, Rebora A. Lupus erythematosus-like eruption from captopril. Acta Derm Venereol. 1985;65:447–8.
Sieber C, Grimm E, Follath F. Captopril and systemic lupus erythematosus syndrome. BMJ. 1990;301:669.
Bertin P, Kamdem J, Bonnet C, Arnaud M, Treves R. Captopril-induced lupus. Clin Exp Rheumatol. 1993;11:695.
Carter JD, Valeriano-Marcet J, Kanik KS, Vasey FB. Antinuclear antibody-negative, drug-induced lupus caused by lisinopril. South Med J. 2001;94:1122–3.
Srivastava M, Rencic A, Diglio G, Santana H, Bonitz P, Watson R, et al. Drug-induced, Ro/SSA-positive cutaneous lupus erythematosus. Arch Dermatol. 2003;139:45–9.
Fernandez-Diaz ML, Herranz P, Suarez-Marrero MC, Borbujo J, Manzano R, Casado M. Subacute cutaneous lupus erythematosus associated with cilazapril. Lancet. 1995;345:398.
Reidenberg MM, Case DB, Drayer DE, Reis S, Lorenzo B. Development of antinuclear antibody in patients treated with high doses of captopril. Arthritis Rheum. 1984;27:579–81.
Pérez-Ferriols A, Martínez-Menchón T, Fortea JM. Follicular mucinosis secondary to captopril-induced photoallergy. Actas Dermosifiliogr. 2005;96:167–70.
Rodríguez Granados MT, Abalde T, García Doval I, De la Torre C. Systemic photosensitivity to quinapril. J Eur Acad Dermatol Venereol. 2004;18:389–90.
Wagner SN, Welke F, Goos M. Occupational UVA-induced allergic photodermatitis in a welder due to hydrochlorothiazide and ramipril. Contact Dermatitis. 2000;43:245–6.
Smit AJ, Van der Laan S, De Monchy J, Kallenberg CG, Donker AJ. Cutaneous reactions to captopril. Predictive value of skin tests. Clin Allergy. 1984;14:413–9.
Miralles R, Pedro-Botet J, Farre M, Rubies-Prat J. Captopril and vasculitis. Ann Intern Med. 1988;109:514.
Laaban J, Marie JP, Wallach D, Blanchard D, Lafay M, Gruffaz F. Necrotising vasculitis associated with captopril therapy. Eur Heart J. 1987;8:319.
Guillevin L, Le Roux G, Breau JL. Leukocytoclasic vasculitis during treatment with low-dose captopril. Ann Med Interne (Paris). 1987;138:658–9.
Jensen ON, Ahlquist P. Schoenlein-Henoch purpura in a geriatric patient after captopril therapy. Ugeskr Laeger. 1996;158:4926–7.
Carrington PR, Sanusi ID, Zahradka S, Winder PR. Enalapril-associated erythema and vasculitis. Cutis. 1993;51:121–3.
Goncalves R, Cortez Pinto H, Serejo F, Ramalho F. Adult Schonlein-Henoch purpura after enalapril. J Intern Med. 1998;244:356–7.
Moots RJ, Keeling PJ, Morgan SH. Adult Schonlein-Henoch purpura after enalapril. Lancet. 1992;340:304–5.
Ayani I, Martinez MJ, Lekuona I, Manrique P. Enalapril-induced vasculitis. Med Clin (Barc). 1991;96:596.
Barlow RJ, Schulz EJ. Lisinopril-induced vasculitis. Clin Exp Dermatol. 1988;13:117–20.
Disdier P, Harle JR, Verrot D, Jouglard J, Weiller PJ. Adult Schonlein-Henoch purpura after lisinopril. Lancet. 1992;340:985.
Gupta S, Gandhi NM, Ferguson J. Cutaneous vasculitis secondary to ramipril. J Drugs Dermatol. 2004;3:81–2.
Cnudde F, Leynadier F, Dry J. Cutaneous reaction to captopril: value of patch tests. Contact Dermatitis. 1990;23:375–6.
Pfützner W, Rueff F, Przybilla B. Systemic contact dermatitis due to captopril without cross-sensitivity to fosinopril, quinapril and benazepril. Acta Derm Venereol. 2004;84:91–2.
Martinez JC, Fuentes MJ, Armentia A, Vega JM, Fernandez A. Dermatitis to captopril. Allergol Immunopathol (Madr). 2001;29:279–80.
Touraud JP, Collet E, Louguet C, Sgro C, Dalac S, Dutronc Y, Lambert D. Cross-sensitivity between angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonist. Ann Dermatol Venereol. 2002;129:1033–6.
Solinger AM. Exfoliative dermatitis from captopril. Cutis. 1982;29:473–4.
O’Neill PG, Rajan N, Charlat ML, Bolli R. Captopril-related exfoliative dermatitis. Tex Med. 1989;85:40–1.
Goodfield MJ, Millard LG. Severe cutaneous reactions to captopril. Br Med J (Clin Res Ed). 1985;290:1111.
Pennell DJ, Nunan TO, O’Doherty MJ, Croft DN. Fatal Stevens-Johnson syndrome in a patient on captopril and allopurinol. Lancet. 1984;1:463.
Alkurtass DA, Al-Jazairi AS. Possible captopril-induced toxic epidermal necrolysis. Ann Pharmacother. 2003;37:380–3.
Winfred RI, Nanda S, Horvath G, Elnicki M. Captopril-induced toxic epidermal necrolysis and agranulocytosis successfully treated with granulocyte colony-stimulating factor. South Med J. 1999;92:918–20.
Oskay T, Ozcelik T, Kutluay L. Stevens-Johnson Syndrome associated with ramipril. Int J Dermatol. 2003;42:580–1.
Chaabane A, Fadhl NB, Chadly Z, Fredj NB, Boughattas NA, Aouam K. Captopril-induced DRESS: first reported case confirmed by patch test. Dermatitis. 2013;24:255–7.
Pileri A, Brunasso AM, Tilz H, Wolf P, Massone C. Ramipril-induced drug reaction with eosinophilia and systemic symptoms (DRESS). Eur J Dermatol. 2011;21:624–5.
Motel PJ. Captopril and alopecia: a case report and review of known cutaneous reactions in captopril use. J Am Acad Dermatol. 1990;23:124–5.
Leaker B, Whitworth JA. Alopecia associated with captopril treatment. Aust N Z J Med. 1984;14:866.
Ahmad S. Enalapril and reversible alopecia. Arch Intern Med. 1991;151:404.
Litt JZ. Drug eruption reference manual. 19th ed. Boca Raton: CRC Press (Taylor and Francis Group); 2013.
Frishman WH, Brosnan BD, Grossman M, Dasgupta D, Sun DK. Adverse dermatologic effects of cardiovascular drug therapy: part II. Cardiol Rev. 2002;10:285–300.
Thestrup-Pedersen K. Adverse reactions in the skin from anti-hypertensive drugs. Dan Med Bull. 1987;34 Suppl 1:3–5.
Torpet LA, Kragelund C, Reibel J, Nauntofte B. Oral adverse drug reactions to cardiovascular drugs. Crit Rev Oral Biol Med. 2004;15:28–46.
Brown RS, Krakow AM, Douglas T. Choksi SK.“Scalded mouth syndrome” caused by angiotensin converting enzyme inhibitors: two case reports. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83:665–7.
Savino LB, Haushalter NM. Lisinopril-induced “scalded mouth syndrome”. Ann Pharmacother. 1992;26:1381–2.
Triantos D, Kanakis P. Stomatodynia (burning mouth) as a complication of enalapril therapy. Oral Dis. 2004;10:244–5.
Habbab KM, Moles DR, Porter SR. Potential oral manifestations of cardiovascular drugs. Oral Dis. 2010;16:769–73.
Clayton R, Chaudhry S, Ali I, Cooper S, Hodgson T, Wojnarowska F. Mucosal (oral and vulval) lichen planus in women: are angiotensin-converting enzyme inhibitors protective, and beta-blockers and non-steroidal anti-inflammatory drugs associated with the condition? Clin Exp Dermatol. 2010;35:384–7. doi:10.1111/j.1365-2230.2009.03581.x.
Schepis C, Lentini M, Siragusa M, Batolo D. ACE-inhibitor-induced drug eruption resembling lymphocytic infiltration (of Jessner-Kanof) and Lupus erythematosus tumidus. Dermatology. 2004;208:354–5.
Borders JV. Captopril and onycholysis. Ann Intern Med. 1986;105:305–6.
Brueggemeyer CD, Ramirez G. Onycholysis associated with captopril. Lancet. 1984;1:1352–3.
Biasi D, Caramaschi P, Carletto A, Bambara LM. Scleroderma and eosinophilic fasciitis in patients taking fosinopril. J Rheumatol. 1997;24:1242.
O’Neil MB, Balfe JW, Geary DF. Captopril related hyperpigmentation. Br Med J. 1987;295:333.
Magro CM, Crowson AN, Schapiro BL. The interstitial granulomatous drug reaction: a distinctive clinical and pathological entity. J Cutan Pathol. 1998;25:72–8.
Perrin C, Lacour JP, Castanet J, Michiels JF. Interstitial granulomatous drug reaction with a histological pattern of interstitial granulomatous dermatitis. Am J Dermatopathol. 2001;23:295–8.
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Özkaya, E., Yazganoğlu, K.D. (2014). Angiotensin-Converting Enzyme Inhibitors. In: Adverse Cutaneous Drug Reactions to Cardiovascular Drugs. Springer, London. https://doi.org/10.1007/978-1-4471-6536-1_2
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