Pityriasis rosea-like drug eruption due to nortriptyline in a patient with vulvodynia

J Low Genit Tract Dis. 2013 Apr;17(2):226-9. doi: 10.1097/LGT.0b013e31825d7c5f.

Abstract

Background: Nortriptyline and other tricyclic antidepressants are widely used in the treatment of depression. They are also used in chronic pain syndromes such as vulvodynia. We report a case of pityriasis rosea (PR)-like eruption in a young woman who was treated with oral nortriptyline for vulvodynia.

Case report: The patient presented with photosensitivity and erythematous, well-defined, oval papules and patches, with fine collarettes of scale on the dorsal hands, upper arms, and trunk. She showed a complete resolution of her rash with discontinuation of nortriptyline, thereby supporting the diagnosis of a drug-induced reaction.

Comment: Pityriasis rosea-like drug eruptions have been associated with numerous medications, including angiotensin-converting enzyme inhibitors, antirheumatic drugs, lithium, and, more recently, biologics such as imatinib, adalimumab, and etanercept. A literature review did not reveal an association between PR-like drug eruptions and tricyclic antidepressants such as nortriptyline. We report a case of PR-like drug reaction to nortriptyline for clinical interest.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / adverse effects*
  • Drug Eruptions / pathology
  • Female
  • Humans
  • Nortriptyline / administration & dosage
  • Nortriptyline / adverse effects*
  • Pityriasis Rosea / chemically induced*
  • Pityriasis Rosea / pathology
  • Vulvodynia / drug therapy*
  • Young Adult

Substances

  • Antidepressive Agents
  • Nortriptyline