Widespread morbilliform eruption associated with telaprevir: use of dermatologic consultation to increase tolerability.

Abstract:

IMPORTANCE:Telaprevir, combined with pegylated interferon alfa and ribavirin, is an efficacious approach to treat hepatitis C virus infection. A morbilliform eruption associated with telaprevir is a common adverse effect experienced by patients. Current guidelines mandate telaprevir discontinuation in any patient with a severe, progressive, or unresponsive cutaneous eruption. OBSERVATIONS:Eight patients with a grade 3 (severe) widespread morbilliform eruption associated with telaprevir were referred to dermatology for evaluation and treatment. Each patient received a combination of antihistamines, topical corticosteroids, and thick emollient creams, rendering their eruption tolerable for the duration of treatment. No patients had evidence of a systemic or life-threatening drug reaction, developed a systemic drug eruption, or had to prematurely stop triple therapy secondary to a cutaneous eruption. CONCLUSIONS AND RELEVANCE:Patients with an uncomplicated grade 3 (severe) widespread morbilliform eruption associated with telaprevir may be able to continue triple therapy with close monitoring and dermatologic consultation. Given our findings, we propose an additional clinical classification of the telaprevir-associated eruption to better reflect the dermatologic classification of drug eruptions.

journal_name

JAMA Dermatol

journal_title

JAMA dermatology

authors

Strazzula L,Pratt DS,Zardas J,Chung RT,Thiim M,Kroshinsky D

doi

10.1001/jamadermatol.2013.9938

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

756-9

issue

7

eissn

2168-6068

issn

2168-6084

pii

1857532

journal_volume

150

pub_type

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