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Case Report
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| Erythropoietin induced miliaria crystallina: A possible new adverse effect of erythropoietin | ||||||
| Sumir Kumar1, B.B. Mahajan2, Sandeep Kaur3, Amarbir Singh4 | ||||||
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1MD, Assistant Professor, Department of Dermatology, Venereology & Leprology, GGS Medical College & Hospital, Faridkot, Punjab, India.
2MD, Professor & Head, Department of Dermatology, Venereology & Leprology, GGS Medical College & Hospital, Faridkot, Punjab, India. 3MBBS, Postgraduate Resident, Department of Dermatology, Venereology & Leprology, GGS Medical College & Hospital, Faridkot, Punjab, India. 4MD, Senior Resident, Department of Dermatology, Venereology & Leprology, GGS Medical College & Hospital, Faridkot, Punjab, India. | ||||||
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| How to cite this article |
| Kumar S, Mahajan BB, Kaur S, Singh A. Erythropoietin induced miliaria crystallina: A possible new adverse effect of erythropoietin. Int J Case Rep Images 2014;5(9):634–637. |
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Abstract
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Introduction:
Erythropoietin, also known as EPO, is used for the treatment of anemia of chronic kidney disease. Usually, the drug is well tolerated with only a few side effects. Adverse effects are mostly systemic with hypertension being seen frequently. Various cutaneous side effects include pruritus, rash, urticaria and erythema. However, miliaria induced by erythropoietin has not been reported so far.
Case Report: A 74-year-old female was referred from medicine department with possibility of toxic epidermal necrolysis. She developed crops of non-itchy tiny vesicles filled with clear fluid on body for the last three days. Injection erythropoietin was given six hours prior to onset of rash. Similar episode occurred one week back after the use of erythropoietin. There was no history of any acute febrile illness. She was a known case of hypertension, diabetes mellitus with chronic kidney disease. There was no change in the treatment plan for the above mentioned complaints except introduction of erythropoietin recently for the management of severe anemia secondary to chronic kidney disease. The diagnosis of miliaria crystallina was made clinically and spontaneous resolution occurred in about seven days. Conclusion: This case adds erythropoietin among the list of drugs precipitating miliaria crystallina which is being reported for the first time in literature. Recognizing this otherwise benign clinical entity is important as it can be confused with severe drug reactions such as toxic epidermal necrolysis. The absence of inflammatory signs in skin, lack of mucosal involvement, no systemic manifestations and spontaneous resolution can help to distinguish it from other drug reactions. | |
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Keywords:
Erythropoietin, EPO, Miliaria, Eccrine sweat glands
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Author Contributions
Sumir Kumar – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published B.B. Mahajan – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Sandeep Kaur – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Amarbir Singh – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2014 Sumir Kumar et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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