Photodistributed felodipine-induced facial telangiectasia

Photodistributed eruptive telangiectasias: an uncommon adverse drug reaction. A retrospective case series

Drug-induced photodistributed telangiectasia (PT) is cutaneous side effects resulting from the interaction of ultraviolet (UV) radiation with pharmacotherapy. Reports of PT in literature are scarce. We report twenty-five cases of drug-induced photodistributed telangiectasias, highlighting the potential relationship between the onset of skin lesions, drug-intake and photo-exposure. We alert practitioners that telangiectasia is a possible dermatological phototoxic side-effect to many drugs.

Computational Studies on the Encapsulation of 1,4-Dihydropyridine Derivatives into CNT(10,10)

Semiempirical and density functional theory (DFT) methods were herein used to study the encapsulation process of 1,4-dihydropyridine (DHP) derivatives into (10,10) armchair carbon nanotube (CNT(10,10)). The encapsulated DHPs do not affect the overall structural and electronic properties of the CNT(10,10). The following binding energy was obtained from DFT-D3 calculations: DHP_Cl2@CNT(10,10) (–62.36 kcal mol–1) < DHP_Ph@CNT(10,10) (–54.71 kcal mol–1) < DHP_OH@CNT(10,10) (–43.92 kcal mol–1) < DHP_NO2@CNT(10,10) (–41.71 kcal mol–1) < DHP_H@CNT(10,10) (–32.74 kcal mol–1). The increase in the dipole moment for all DHPs@CNT(10,10) indicates their partial solubility in water. Our results play a promising role as a guide for future experiments using CNTs as a vehicle to transport DHP derivatives.

[Telangiectasia during amlodipine therapy]

BACKGROUND

Calcium inhibitors are recommended as first-line treatment in hypertension. We report the development of telangiectasia on the trunk and upper limbs in a female patient on amlodipine (Amlor(®)) that subsided on treatment discontinuation.

PATIENTS AND METHODS

A 63-year-old woman consulted for numerous asymptomatic stellate telangiectasias on her upper trunk and shoulders, with sparing of the face. No Darier's sign was seen and clinical examination was otherwise normal. The patient had been treated with amlodipine (Amlor(®)) and a combination of bisoprolol and hydrochlorothiazide (Lodoz(®)) for 5years for essential hypertension. Laboratory tests, which included serum tryptase assay, were normal. Histological analysis showed a normal epidermis with dilated superficial dermal capillaries and no inflammatory infiltrate or dermal elastosis. Amlodipine was discontinued and replaced with ramipril (an ACE inhibitor). The other treatments were changed over and the telangiectasias regressed spontaneously within several months, with no relapse being seen at one year of follow-up.

COMMENTS

Reports of telangiectasia associated with calcium inhibitors most commonly involve the dihydropyridine family, of which amlodipine is a member. Inhibition of muscular contraction induced by this treatment results in vasodilatation, accounting for the associated antihypertensive properties, and this could play a role in telangiectasia formation. The literature contains reports of cases of photo-distributed telangiectasia, suggesting that as well as vasodilatation, calcium inhibitors may in certain cases cause abnormal sensitivity of blood vessels to ultraviolet radiation. The absence of facial lesions rules out the hypothesis of photo-induced lesions in our patient.

Photo-damage in Northern European renal transplant recipients is associated with use of calcium channel blockers

Photo-damage of the head and neck was assessed, by visual inspection, in 82 Northern European renal transplant recipients attending a dermatology clinic. Photo-damage was graded as absent, mild, moderate and severe and the presence or absence of skin telangiectasia, solar elastosis, erythema and pigmentation was assessed. The duration and type of immunosuppressant and calcium channel blocker medication was recorded. Ninety percent had photo-damaged skin with 41 (50%) having mild photo-damage, 20 (24%) moderate photo-damage and 13 (16%) severe photo-damage. Sixty-two (76%) had pigmentation, 43 (52%) telangiectasia, 65 (79%) papular changes and 51 (65%) erythema. Fifty-three patients (65%) had received a calcium channel blocker (49 nifedipine, four amlodipine). The grade of photo-damage was strongly associated with use of calcium channel blockers (P=0.001) as was the presence of telangiectasia (P=0.001) and solar elastosis (P=0.04). Photo-damage is frequent in this population of renal transplant patients. Telangiectasia in association with calcium channel blockers has been reported rarely but appears to be common in the transplant population.