Schoefer H, Ochsendorf FR, Bauer H, Milbradt R, Stille W; International Conference on AIDS.
Int Conf AIDS. 1989 Jun 4-9; 5: 339 (abstract no. T.B.P.316).
Klinikum der J.W. Goethe Universitat, Dept. of Dermatology, Frankfurt, FRG
OBJECTIVE: To evaluate the prevalence, clinical morphology and course of cutaneous reactions to TMP-SMZ in the treatment of HIV-associated PCP. METHODS: Prospective clinical and morphological examination for untoward skin reactions in the treatment of 76 consecutive episodes of PCP in 61 patients (51 first manifestations, 25 relapses) with TMP (20 mg/kg) -SMZ (100mg/kg) per day. RESULTS: Patients with first PCP-episodes (group I) showed cutaneous rashes in 23% (12/51). Patients with recurrent PCP (group II) and the same therapy regimen in 56% (14/25). Cutaneous eruptions (exanthema) occurred 10,7 days after the onset of therapy in group I and remarkably earlier (mean 7,5 days) in group II. IN typical cases there was a non itching erythema, beginning in the patients face, extending in craniocaudal direction 2-4 days prior to exanthema. In 77% exanthema consisted of disseminated small red maculae with confluence and pruritus. 3 patients developed a maculopapular, 2 an urticarial exanthema and another 2 erythema multiforme (in 1 patient with progression to Stevens-Johnson syndrome). TMP-SMZ therapy had to be stopped in 11/26 patients with cutaneous reactions. CONCLUSIONS: Cutaneous eruptions in the treatment of PCP with TMP-SMZ are very frequent but not homogeneous. Besides probably toxic reactions (facial and truncal erythema) we observed urticarial, maculopapular eruptions and severe erythema multiforme. Simple erythema does not force to stop therapy when high doses of antihistamines are given. However, when mucosal lesions occur (Stevens-Johnson-syndrome, toxic epidermal necrolysis) TMP-SMZ therapy has to be stopped.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Antiretroviral Therapy, Highly Active
- Disease Progression
- Drug Therapy, Combination
- Epidermal Necrolysis, Toxic
- Erythema Multiforme
- Exanthema
- HIV Infections
- HIV Seropositivity
- Humans
- Longitudinal Studies
- Pneumonia, Pneumocystis
- Prevalence
- Receptors, Cell Surface
- Stevens-Johnson Syndrome
- Trimethoprim-Sulfamethoxazole Combination
- drug therapy
- epithelial membrane protein-1
- therapy
Other ID:
UI: 102177569
From Meeting Abstracts