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© 1993 British Society for Rheumatology

research-article

SUSPECTED CUTANEOUS DRUG TOXICITY IN RHEUMATOID ARTHRITIS—AN EVALUATION

S. M. WILKINSON*,, A. G. SMITH*, M. J. DAVIS{dagger}, D. L. MATTEY{dagger}; and P. T. DAWES{dagger}

*Dermatology Department, North Staffordshire Hospital Centre Stoke-on-Trent ST4 7PA
{dagger}Staffordshire Rheumatology Centre, Haywood Hospital Stoke-on-Trent ST6 7AG

Correspondence to: Correspondence to: S. M. Wilkinson. The Skin Hospital, Chapel Street, Salford, Lancashire M60 9EP

Cutaneous toxicity from drugs used to treat RA is a major perceived problem. Over a 2-yr period we have prospectively reviewed 114 patients with a suspected adverse cutaneous reaction to anti-rheumatic drugs. In 71 (62%), the rash was thought to be unrelated to drug therapy. This group included 10 in whom the rash had resolved before review (usually < 1 week), 38 with a rash related to their rheumatoid disease and 23 with eruptions unrelated to either drugs or arthritis. Fortythree (38%) patients had rashes thought to be related to their drug therapy. Gold therapy (both oral and intramuscular) was implicated most frequently (31 patients). However, the majority of these (23) had a pityriasiform/discoid eczematous eruption that responded to potent topical steroids occasionally with a reduction in gold dosage.

In this sample it was possible to continue drug therapy in 82% of patients with what were initially thought to be cutane ous adverse drug reactions. Careful evaluation should allow a majority of patients to continue drug therapy from which they are often gaining benefit.

KEY WORDS: Rheumatoid arthritis, Cutaneous drug toxicity, Vasculitis, Capillaritis, Pruritus, Asteatotic eczema, Pityriasis rosea, Discoid eczema, Pemphigus, Alopecia


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