Domperidone-induced pityriasis rosea-like drug eruption.

Pityriasis rosea is a common, acute, self limiting inflammatory skin disease. Pityriasis rosea-like eruptions (PR-LE) have been reported after drugs. The clinical presentation of PR-LE can be distinguished from pityriasis rosea. We reporte a 41-year-old woman who developed PR-LE 5 days after administration domperidone.

CASE OBSERVATION

A 41‐year‐old woman, G2P1 presented at the 12th week of pregnancy with a pruritic eruption on the upper and lower limbs, neck, and trunk. The eruption appeared 5 days after the administration of domperidone. No symptoms of viral infection were observed in the previous week. The dermatological examination revealed scattered erythematous and squamous lesions on the arms, chest, and abdomen (Figure 1A), and confluently scaly plaques of the lower back. Histological examination revealed signs of a drug reaction (Figure 2). The rash disappeared 2 weeks after discontinuing the treatment (Figure 1B).

FIGURE 1

(A) Erythematous and squamous lesions on the trunk. (B) Without topical treatment, the lesions disappeared two weeks after discontinuing domperione

FIGURE 2

(A) (HE ×100), Parakeratotic hyperkeratosis in front of acanthotic rete pegs. Perivascular lymphocytic and eosinophilic infiltrate in dermis. (B) (HE ×200): Rare apoptotic bodies in the epidermis

DISCUSSION

Pityriasis rosea is a common, acute, self‐limiting inflammatory skin disease due to the endogenous systemic reactivation of human herpesvirus‐6 (HHV‐6) and/or ‐7 (HHV‐7). Pityriasis rosea‐like eruptions (PR‐LE) have been reported after drugs. Recently, several cases have been reported of PR‐LE after COVID‐19 vaccines.  The clinical presentation of PR‐LE can be distinguished from PR. Herald patch and Prodromal systemic symptoms are absent in PR‐LE and lesions are more confluent forming large itchy lesions.

Skin reactions to domperidone have been described in two cases represented by systemic lupus‐like syndrome and general diffuse erythema with some pustules. The pathophysiology between domperidone and these different reactions is not well understood, it is probably multifactorial and complex.

CONFLICTS OF INTEREST

None.

AUTHOR CONTRIBUTIONS

Dr Sarra Saad involved in writing the manuscript and submitting the revised article. Dr Rima Gammoudi out the analysis of the manuscript. Dr Nihed Abdessayed involved in writing the histological part of the manuscript. Dr Denguezli Mohamed supervised and approved the revised manuscript.

ETHICAL APPROVAL

None.

CONSENT

Written informed consent was obtained from the patient to publish this report in accordance with the journal's patient consent policy.