Drug-Induced Erythema Dyschromicum Perstans

Drug-Induced Erythema Dyschromicum Perstans

Article
Allergy
Skin Care
+1
Contributed byLester Fahrner, MD+1 moreJan 02, 2022

What are the other Names for this Condition? (Also known as/Synonyms)

  • Drug-Induced EDP
  • Medication-Induced EDP
  • Medication-Induced Erythema Dyschromicum Perstans

What is Drug-Induced Erythema Dyschromicum Perstans? (Definition/Background Information)

  • Erythema dyschromicum perstans (EDP) is a benign skin condition that manifests as grey-colored and well-defined patches, commonly on the head and neck region. It may be caused by the use of certain chemicals, pesticides, and in some cases, a positive family history of EDP
  • Drug-Induced Erythema Dyschromicum Perstans is caused by the use of certain medications, such as antibiotics, proton pump inhibitors, or certain anti-anxiety medications. It may be considered as a reactive condition of the body to the drug
  • The condition may be observed in children and adults. Apart from the discolored skin patches, no other symptoms of Drug-Induced Erythema Dyschromicum Perstans are generally noted. However, scratching the itchy lesions may result in secondary infections
  • Stopping or discontinuing the use of such medications may decrease progression of Drug-Induced Erythema Dyschromicum Perstans, or may result in a cure. The prognosis is good in a majority of cases with adequate treatment

Who gets Drug-Induced Erythema Dyschromicum Perstans? (Age and Sex Distribution)

  • Drug-Induced Erythema Dyschromicum Perstans is an uncommon skin condition caused by a variety of medications that are administered for other underlying conditions. Hence, any individual of any age may be at risk
  • Both males and females may be affected
  • Individuals of all racial and ethnic background can be affected. But, in general, erythema dyschromicum perstans affects darker-skinned individuals more, such as Indians (belonging to the Indian subcontinent) and South and Central Americans

What are the Risk Factors for Drug-Induced Erythema Dyschromicum Perstans? (Predisposing Factors)

The key risk factor for Drug-Induced Erythema Dyschromicum Perstans is the use of certain medications that cause the skin condition as a side effect. The medications observed to induce this abnormal skin growth include:

  • Antibiotics that include penicillin
  • Psychoactive drugs such as benzodiazepine
  • Omeprazole, a proton pump inhibitor

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Drug-Induced Erythema Dyschromicum Perstans? (Etiology)

The exact cause of development of Drug-Induced Erythema Dyschromicum Perstans is presently unknown.

  • The condition can be defined as an adverse reaction of the body to certain medications that are used for various health conditions. This results in the formation of lesions on skin
  • Having HLA-DR4 genotype is known to increase the risk for erythema dyschromicum perstans

What are the Signs and Symptoms of Drug-Induced Erythema Dyschromicum Perstans?

The signs and symptoms of Drug-Induced Erythema Dyschromicum Perstans include:

  • The benign lesions appear as slightly elevated, well-circumscribed patches; multiple patches of varying sizes may be observed
  • They are typically ash or grey in color
  • The lesions may itch leading to scratching and bleeding; itching may be mild in many cases
  • Erythema dyschromicum perstans commonly affects the head and neck region; uncommonly, it may be present on the trunk, arms and legs too
  • Sometimes, both sides of the body may be involved
  • No other associated signs and symptoms are generally noted

The severity of the signs and symptoms may be related to the type and usage of the drug.

How is Drug-Induced Erythema Dyschromicum Perstans Diagnosed?

A diagnosis of Drug-Induced Erythema Dyschromicum Perstans may involve the following:

  • A complete physical examination and a thorough medical history (which includes the use of any drugs and topical applications)
  • Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
  • Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
  • Skin biopsy, if necessary: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Drug-Induced Erythema Dyschromicum Perstans?

Drug-Induced Erythema Dyschromicum Perstans is a benign condition that does not cause any significant complications. However in some individuals, the following complications may be noted:

  • Cosmetic issues resulting in emotional stress
  • Secondary bacterial and fungal infection: Continuous itching and scaling of the skin will create skin moistness, providing a suitable environment for bacteria and fungi to grow and thrive

How is Drug-Induced Erythema Dyschromicum Perstans Treated?

  • Discontinuing the drug or topical cream responsible for the side effect may result in a cure, or in improvement of Drug-Induced Erythema Dyschromicum Perstans
  • If necessary, the following treatment measures may be attempted:
    • Use of topical steroid creams
    • Ultraviolet light therapy
    • Chemical skin peels
    • Laser treatments
    • Use of medications such as clofazimine, dapsone, and isoniazid
  • Administration of antifungal or antibiotic medication, in case of any secondary infection

Follow-up care with regular screening and check-ups are important and encouraged.

How can Drug-Induced Erythema Dyschromicum Perstans be Prevented?

Current medical research has not established a method of preventing Drug-Induced Erythema Dyschromicum Perstans. However, the following may be observed:

  • Drugs that cause erythema dyschromicum perstans may be discontinued or alternative medications used
  • Inform your physician if you are allergic to certain drugs
  • Periodic monitoring or follow-up of the condition with the healthcare provider is recommended

What is the Prognosis of Drug-Induced Erythema Dyschromicum Perstans? (Outcomes/Resolutions)

The prognosis for Drug-Induced Erythema Dyschromicum Perstans is usually good, in many cases, upon discontinuation of the medication and adequate treatment of the skin condition.

Additional and Relevant Useful Information for Drug-Induced Erythema Dyschromicum Perstans:

  • Do not pick or pop the blisters, for doing so can affect the healing process and may result in secondary infections
  • Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
  • The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse
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On the Article

Krish Tangella MD, MBA picture
Approved by

Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team
Lester Fahrner, MD picture
Reviewed by

Lester Fahrner, MD

Chief Medical Officer, DoveMed Team

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