Drug-induced Papuloerythroderma: Analysis of T-cell Populations and a Literature Review

Abstract

Papuloerythroderma of Ofuji is characterized by coalescent solid papules that spare the skin folds. Although cutaneous lymphomas and internal malignancies are known associated conditions, the causative agents are unclear in most cases. A number of recent reports have documente d that drugs can induce papuloerythroderma. We review ed the reported cases and our own cases of drug-induc ed papulo erythroderma, together with our data from lympho cyte transformation tests and T-cell subsets of peri pheral blood. All of the 9 patients were male, and the causative drugs were various. Provocation tests were positive in all 6 patients examined. Whereas drug patch tests were negative in all 5 cases tested, the patient’ peripheral blood lymphocytes responded well to the culprit drug in 4 of 5 patients tested. The patients had higher percentages of circulating CCR4+CD4+ T helper (Th) 2 cells than CXCR3+CD4+ Th1 cells. Drug-induced papuloerythroderma seems to be mediated by Th2 cells reacting with the causative drug.