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Chlorpromazine-induced lupuslike disease. Case report and review of the literature
Authors:G P Pavlidakey  K Hashimoto  G L Heller  S Daneshvar
Institution:From the Department of Dermatology and Syphilology, Wayne State University School of Medicine.
Abstract:A lupuslike disease with cutaneous manifestations secondary to the use of chlorpromazine (Thorazine) is presented. Skin biopsy specimens demonstrated classic findings consistent with lupus erythematosus and abundant mucin deposition in the cutaneous lesions--a finding not previously reported to occur in drug-induced lupuslike disease. Laboratory and serologic examinations included a positive antinuclear antibody titer, presence of single-stranded deoxyribonucleic acid (DNA), absence of double-stranded DNA, presence of antihistone antibodies, normal complement level, increased IgM level, and prolongation of partial thromboplastin time. These data confirmed our clinical and histologic diagnosis. Cessation of the medication (chlorpromazine) led to resolution of the skin abnormalities. Electron microscopy revealed electron-dense drug metabolites in vascular endothelial cells, as well as tubuloreticular inclusion bodies. This is only the second reported case of chlorpromazine-induced lupuslike disease with cutaneous manifestations.
Keywords:Reprint requests to: Dr  Ken Hashimoto  Wayne State University  Dept  of Dermatology  540 E  Canfield  Detroit  MI 48201  
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