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case report

Pharmacoepidemiology and Risk Management 2023; 15(1): 94-99

Published online March 31, 2023 https://doi.org/10.56142/perm.23.0003

Copyright © Korean Society for Pharmacoepidemiology and Risk Management.

A Case of Generalized Maculopapular Rash Induced by Letrozole and Anastrozole

Letrozole 및 Anastrozole에 의한 반구진 발진 1예

Sun Kim1, Hyun Jee Kim2,3, Jin Yoon2,3, Jang-Ho Seo2,3, Ju-Yeun Lee1, Hye-Ryun Kang2,3,4

김선1, 김현지2,3, 윤진2,3, 서장호2,3, 이주연1, 강혜련2,3,4

1College of Pharmacy, Seoul National University, Seoul, Korea
2Drug Safety Center, Seoul National University Hospital, Seoul, Korea
3Regional Pharmacovigilance Center, Seoul National University Hospital, Seoul, Korea
4Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea

1서울대학교 약학대학, 2서울대학교병원 약물안전센터, 3서울대학교병원 지역의약품안전센터, 4서울대학교 의과대학 내과학교실

Correspondence to:Hye-Ryun Kang
Departmentof Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
Tel: +82-2-2072-0820
Fax: +82-2-742-3291
E-mail: helenmed@snu.ac.kr

Received: February 23, 2023; Revised: March 10, 2023; Accepted: March 13, 2023

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aromatase inhibitors are widely used as a treatment for postmenopausal women with hormone receptor-positive breast cancer. They are classified as type 1 steroidal or type 2 nonsteroidal agents. Letrozole and anastrozole are the most frequently used type 2 nonsteroidal inhibitors that share common structure and bind reversibly to aromatase. Both are generally well tolerated; while type A adverse reactions such as hot flashes, vaginal dryness, musculoskeletal pain, and headache can occur, drug hypersensitivity reactions are very rare. Here, we present a case of a 55 years old woman who experienced maculopapular rash to letrozole after five days administration. Her symptoms resolved after chlorpheniramine and dexamethasone injection. Then, she took a single dose of letrozole and symptoms were aggravated. Sixteen days after her initial symptom to letrozole, she switched to anastrozole. After taking anastrozole for two days, she developed urticarial rash and stopped anastrozole arbitrarily. Her symptoms resolved after discontinuing anastrozole. Patients and physicians should be aware of potential cross reactivity to both aromatase inhibitors which may be due to the common structure in the aromatase inhibitors.

KeywordsAromatase inhibitors, Drug hypersensitivity, Drug-related side effects and adverse reactions, Letrozole, Anastrozole

Korean Society for Pharmacoepidemiology and Risk Management

Vol.16 No.2
September, 2024

eISSN 2982-5954

Frequency: Bimonthly

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