Case Reports

Exfoliated dermatitis and hepatitis to first line anti-tubercular therapy with treatment of drug-sensitive tuberculosis with second line anti-tubercular therapy: a roller coaster ride

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 30 April 2024
Published: 3 June 2024
2812
Views
750
Downloads

Authors

The Adverse Drug Reactions (ADRSs) to Anti-Tubercular Therapy (ATT) have been reported from 8% to 85% worldwide, while the prevalence of ADRSs to 1st line ATT from India reported 2.3% to 17%, with more during the intensive phase and daily regime. However, cutaneous ADRSs related to ATT are less commonly seen. Common cutaneous ADRSs are maculopapular rash, urticarial, erythema multiforme, exfoliative dermatitis, and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Among the 1st line ATT, pyrazinamide is the most common cause at 2.38%, and isoniazid is reported the least at 0.98%. Exfoliated dermatitis is rarely seen with 1st line ATT therapy limited to some case reports and case series.

Downloads

Download data is not yet available.

Singh A, Prasad R, Balasubramanian V, et al. Prevalence of adverse drug reaction with first-line drugs among patients treated for pulmonary tuberculosis. Clin Epidemiol Glob Health 2015;3:S80-90. DOI: https://doi.org/10.1016/j.cegh.2015.10.005

Sharma RK, Verma GK, Tegta GR, et al. Spectrum of cutaneous adverse drug reactions to antitubercular drugs and safe therapy after rechallenge - A retrospective study. Indian Dermatol Online J 2020;11:177-81. DOI: https://doi.org/10.4103/idoj.IDOJ_133_19

Varghese AM, Kandra N, Uppala PK, et al. Anti-Tubercular Therapy (ATT) induced exfoliative dermatitis A case series. Indian J Tuberc 2023;70:253-7. DOI: https://doi.org/10.1016/j.ijtb.2022.08.001

Dua R, Sindhwani G, Rawat J. Exfoliative dermatitis to all four first line oral anti-tubercular drugs. Indian J Tuberc 2010;57:53-6.

World Health Organization (WHO). WHO consolidated guidelines on tuberculosis. Module 4: treatment – drug-susceptible tuberculosis treatment. 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK581329/

Gillespie SH, Crook AM, McHugh TD, et al. Four-month moxifloxacin-based regimens for drug-sensitive tuberculosis. N Engl J Med 2014;371:1577-87. DOI: https://doi.org/10.1056/NEJMoa1407426

Merle CS, Fielding K, Sow OB, et al. A four-month gatifloxacin-containing regimen for treating tuberculosis. N Engl J Med 2014;371:1588-98. DOI: https://doi.org/10.1056/NEJMoa1315817

Jindani A, Harrison TS, Nunn AJ, et al. High-dose rifapentine with moxifloxacin for pulmonary tuberculosis. N Engl J Med 2014;371:1599-608. DOI: https://doi.org/10.1056/NEJMoa1314210

Turkova A, Wills GH, Wobudeya E, et al. Shorter treatment for nonsevere tuberculosis in African and Indian children. N Engl J Med 2022;386:911-22. DOI: https://doi.org/10.1056/NEJMoa2104535

Dorman SE, Nahid P, Kurbatova EV, et al. Four-month rifapentine regimens with or without moxifloxacin for tuberculosis. N Engl J Med 2021;384:1705-18. DOI: https://doi.org/10.1056/NEJMoa2033400

Mandal PK, Mandal A, Bhattacharyya SK. Comparing the daily versus the intermittent regimens of the antitubercular chemotherapy in the initial intensive phase in non-HIV, sputum positive, pulmonary tuberculosis patients. J Clin Diagn Res 2013;7:292-5.

Blumberg HM, Burman WJ, Chaisson RE, et al. American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med 2003;167:603-62. DOI: https://doi.org/10.1164/rccm.167.4.603

Paton NI, Cousins C, Suresh C, et al. Treatment strategy for rifampin-susceptible tuberculosis. N Engl J Med. 2023;388:873-87. DOI: https://doi.org/10.1056/NEJMoa2212537

How to Cite



Exfoliated dermatitis and hepatitis to first line anti-tubercular therapy with treatment of drug-sensitive tuberculosis with second line anti-tubercular therapy: a roller coaster ride. (2024). Chest Disease Reports, 12(1). https://doi.org/10.4081/cdr.12.12626