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Year : 1995  |  Volume : 61  |  Issue : 1  |  Page : 26-27

Acneform eruptions and antitubercular drugs

Correspondence Address:
R P Sharma

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Source of Support: None, Conflict of Interest: None

PMID: 20952867

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Out of total 774 cases under antitubercular therapy only 11 cases (1.42%) developed acneform eruptions. Individual drugs found to cause these eruptions were Isoniazid (0.53%), Rifampicin (1.48%) and Ethambutol (0.63%).

Keywords: Acneform eruptions, Isoniazid, Rifampicin, Ethambutol

How to cite this article:
Sharma R P, Kothari A K, Sharma N K. Acneform eruptions and antitubercular drugs. Indian J Dermatol Venereol Leprol 1995;61:26-7

How to cite this URL:
Sharma R P, Kothari A K, Sharma N K. Acneform eruptions and antitubercular drugs. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2019 Nov 21];61:26-7. Available from: http://www.ijdvl.com/text.asp?1995/61/1/26/4121

  Introduction Top

Out of various types of skin eruptions induced by antitubercular drugs, acneform eruptions are mild and less common. Isoniazid was the first amongst antitubercular drugs reported to cause acneform lesions.[1] Since then many reports have come,[2][3][4] similarly there is report of rifampicin induced acneform eruptions[5] and ethambutol is also mentioned in literature[6] to cause such eruptions. A study was therefore performed with a view to ascertain the incidence of acneform eruptions in patients receiving antitubercular drugs.

  Materials and Methods Top

Seven hundred and seventy four patients suffering from pulmonary tuberculosis and receiving antitubercular drugs were selected for study from the Outpatient department of Tuberculosis and Chest Diseases, LLRM Medical College, Meerut. Drugs used were isoniazid, thiacetazone, rifampicin, ethambutol, pyrizinamide and streptomycin in different regimens. Detailed history, clinical and cutaneous examination was recorded in each patient. Patients suffering from acne vulgaris or having past history were excluded. Each patient was asked to attend at fortnightly intervals for follow-up. Dechallenge and rechallenge was done as and when required, to confirm the offending drug.

  Results Top

Out of total 774 cases, only 11 cases 1.42%) developed acneform eruptions. Out of 746 cases taking isoniazid only 4 cases (0.53%) developed lesions; while out of 267 cases receiving rifampicin and out of 470 cases receiving ethambutol, 4 cases (1.49%) and 3 cases (0.63%) developed acneform eruptions respectively.

Out of 11 cases, 6 were female and 5 male. Their age ranged from 14 years to 68 years (average 32.3 years). Onset of lesions after starting treatment varied from 3 days to 90 days and disappearance of lesions after discontinuation of offending drug varied from 6 days to 31 days [Table:1] and [Table:2].

  Discussion Top

In present study overall incidence of acneform eruptions in patients under antitubercular therapy was only 1.42%. The incidence of isoniazid induced acneform eruptions was only 0.53%. It is comparatively lower than reported earlier.[1][2][3][4] Incidence of rifampicin induced lesions was 1.49%, which is comparable to previous reports.[5][6][7] Ethambutol was found to cause acneform lesions in 0.63% cases. Though ethambutol is well known to produce skin eruptions[8][9][10] but to the best of our knowledge no one has reported so far acneform eruptions due to ethambutol. However, Davis has mentioned ethambutol as a cause acneform eruptions.[6]

Possible explanation for the development of acne due to isoniazid may be that since it is a structural analogue of niacin, competitive inhibition might predispose to follicular hyperkeratosis in some patients.[3] No possible explanation is available in cases of rifampicin and ethambutal induced acneform eruptions.

  References Top

1.Bereston ES. Reactions to antituberculous drug. J Invest Dermatol. 1959;33:427-39.  Back to cited text no. 1  [PUBMED]  
2.Cohen LK, George W, Smith R. Isoniazid-induced acne and Pellagra. Arch Dermatol. 1974;109:377-81.  Back to cited text no. 2  [PUBMED]  
3.Oliweicki S, Burton JL. Severe acne due to isoniazid. Clin Exp Dermatol 1980;14:283-4.  Back to cited text no. 3    
4.Lobo A, Mathai R, Jacob M. Pathogenesis of drug induced acneform eruptions. Ind J Dermatol venereol Leprol 1992;58:159-63.  Back to cited text no. 4    
5.Purohit SD, Gupta PR, Sharma TN, Chawla MP, Gupta DN. Acne during rifampicin therapy. Ind J Tub 1983;30:110-1.  Back to cited text no. 5    
6.Davis DM. Text Book of Adverse Drug Reactions, 2nd edn. Oxford Medical Publication, 1981;472.  Back to cited text no. 6    
7.Nowokolo U. Acneform lesions in combined rifampicin treatment in Africans. Br Med J 1974;3:473.  Back to cited text no. 7    
8.Pasricha JS, Kanwar AJ. Skin eruptions caused by ethambutol. Arch Dermatol. 1977;113:122-3.  Back to cited text no. 8  [PUBMED]  
9.Mani MZ, Mathew M. A study of 218 drug eruptions. Ind J Dermatol Venereol 1983;49:109-17.  Back to cited text no. 9    
10.Gupta SK, Maine VK, Bedi RS. Cutaneous eruptions due to ethambutol. Ind J Tub 1983;30:125-6.  Back to cited text no. 10    

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