Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature
Abstract
:1. Introduction
2. Bullous Pemphigoid: Epidemiological, Pathogenetic, and Clinical Features
3. Neuropsychiatric Disorders and Bullous Pemphigoid: A Potential Neuroimmunological Origin
4. Antipsychotics as Potential Inducers of BP
4.1. Drugs as Triggering Factors of BP
4.2. Antipsychotics and Bullous Pemphigoid
Source | Study Design, Numbers of Participants | Gender (%), Mean Age Years (±sd) | Psychiatric Diagnoses | Number of Patients (%) and Antipsychotics Treatments |
---|---|---|---|---|
Bastuji-Garin et al., 1996 [67] | Multicenter prospective case-control study, 116 incident cases of BP | F (50%), M (50%) 79.2 (10.1) | Not specified | 18 (15.5%) treated with NSA |
Wijeratne and Webster, 1996 [68] | Case report 1 BP patient | M 74 years | Dementia with psychotic symptoms | Risperidone (4 mg/day) |
Mehravaran et al., 1999 [69] | Case report 1 BP patient | F 73 years | Not specified | Thioridazine, hydrochloride and flupentixol decanoate |
Bastuji-Garin et al., 2011 [36] | Multicenter case-control study, 201 incident cases of BP | F (65%), M (35%) 84.2 (8.7) | Unipolar and bipolar disorders | 24 (11.9%) treated with NSA 13 (6.5%) treated with phenothiazines with aliphatic side chains |
Lloyd-Lavery et al., 2013 [71] | Case-control study 86 cases of BP | F (59.3%), M (40.7%) 81.5 (9.7) | Not specified | 6 (7.0%) treated with NSA No significant differences for antipsychotics |
Varpuluoma et al., 2019 [70] | Retrospective study (Finnish Care Register for Health Care database, 1987–2013) 3397 cases of BP | F (59.7%), M (40.3%) 76.6 | Not specified | 34 (1.0%) Perphenazine 49 (1.4%) Haloperidol 97 (2.9%) Quetiapine 13 (0.4%) Sulpiride 172 (5.1%) Risperidone |
5. The Challenging Case of a Bipolar Patient Presenting Bullous Pemphigoid after Risperidone LAI
6. Discussion
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Antipsychotics | Dermatologic Features of CDRs | |
---|---|---|
FGAs (typical) | Chlorpromazine | Pruritus, drug-induced pigmentation, exanthematous reactions, urticaria, exfoliative dermatitis, photosensitivity, erythema multiforme, Stevens-Johnson syndrome, angioedema |
Fluphenazine | Pruritus, exanthematous reactions, urticaria drug-induced pigmentation, exanthematous reactions | |
Flupentixol | Drug-induced pigmentation, exanthematous reactions, bullous pemphigoid | |
Haloperidol | Exanthematous reactions, fixed drug eruptions, acneiform eruptions, drug-induced pigmentation, alopecia, exanthematous reactions, photosensitivity, hyperhidrosis | |
Perphenazine | Pruritus, exanthematous reactions, urticaria, drug-induced pigmentation | |
SGAs (atypical) | Aripiprazole | Exanthematous reactions, alopecia, acneiform eruptions, onycholysis |
Clozapine | Pruritus, exanthematous reactions, urticaria, drug-hypersensitivity vasculitis, drug-induced pigmentation, erythema multiforme, photosensitivity, Stevens-Johnson syndrome, angioedema | |
Olanzapine | Pruritus, exanthematous reactions, urticaria, fixed drug eruptions, photosensitivity, drug-induced pigmentation, alopecia, seborrheic dermatitis, hyperhidrosis, drug-hypersensitivity vasculitis, exanthematous reactions | |
Quetiapine | Pruritus, exanthematous reactions, fixed drug eruptions, photosensitivity, acneiform eruptions, drug-induced pigmentation, seborrheic dermatitis, hyperhidrosis, exfoliative dermatitis, psoriasiform reactions, angioedema | |
Ziprasidone | Exanthematous reactions, exfoliative dermatitis, urticaria, photosensitivity, alopecia, angioedema | |
Paliperidone | Toxic epidermal necrolysis, exanthematous rash | |
Risperidone | Pruritus, exanthematous reactions, urticaria, alopecia, drug-induced pigmentation, acneiform eruptions, seborrheic dermatitis, hyperhidrosis, erythema multiforme, exfoliative dermatitis, psoriasiform reactions, photosensitivity, angioedema, bullous pemphigoid |
Elderly age: usual onset after 75 years of age |
Pre-existing skin diseases: psoriasis, atopic dermatitis, and lichen |
Bedridden conditions: immobility, muscle weakness, low self-sufficiency |
Severe cognitive impairment |
Polypharmacotherapy: loop diuretics, spironolactone, dipeptidyl peptidase-IV inhibitors, and antipsychotics |
Pharmacodynamic/pharmacokinetic drug interactions |
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Fabrazzo, M.; Boccardi, M.; Cipolla, S.; Galiero, R.; Tucci, C.; Perris, F.; Di Caprio, E.L.; Catapano, F.; Sasso, F.C. Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature. Brain Sci. 2021, 11, 1386. https://doi.org/10.3390/brainsci11111386
Fabrazzo M, Boccardi M, Cipolla S, Galiero R, Tucci C, Perris F, Di Caprio EL, Catapano F, Sasso FC. Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature. Brain Sciences. 2021; 11(11):1386. https://doi.org/10.3390/brainsci11111386
Chicago/Turabian StyleFabrazzo, Michele, Mariangela Boccardi, Salvatore Cipolla, Raffaele Galiero, Claudia Tucci, Francesco Perris, Ester Livia Di Caprio, Francesco Catapano, and Ferdinando Carlo Sasso. 2021. "Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature" Brain Sciences 11, no. 11: 1386. https://doi.org/10.3390/brainsci11111386
APA StyleFabrazzo, M., Boccardi, M., Cipolla, S., Galiero, R., Tucci, C., Perris, F., Di Caprio, E. L., Catapano, F., & Sasso, F. C. (2021). Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature. Brain Sciences, 11(11), 1386. https://doi.org/10.3390/brainsci11111386