Drug Eruptions of the Scalp


Allopurinol

Beta-blockers

Androgens

Ergots

Anticholesterol agents (statins)

Hormones (OCPs, HRT)

Anticoagulants

Dopa

Anticonvulsants

Immunomodulators

Antifungals

Retinoids (vitamin A)

Antihistamines (H2)

Psychotropics

Anti-inflammatory

Minoxidil

Anti-mitotic

Heavy metals (gold)

Anti-thyroid

SERMS and phytoestrogens





  • Androgen s, (such as testosterone, hormonal therapies with androgenic progesterones or testosterone, DHEAS, and anabolic steroids) can induce TE and alopecia.


  • Anticoagulants (such as coumadin, heparin, heparinoids, and enoxaparin) can produce a TE.


  • Anticonvalsants (such as Carbamazepine and valproic acid) have been reported to occasionally induce a TE. The suggested mechanism is altered or reduced zinc and selenium levels.


  • Antidepressants (such as amphetamines, imipramine, desipramine, fluoxetine, sertaline, and dixyrazine) can produce a TE. Lithium induces hypothyroidism and can result in TE and alopecia.


  • Antifungal drugs (such as fluconazole and ketoconazole in high doses) have induced a reversible TE.


  • Antiinflammatory drugs (such as chronic NSAIDs) have induced a reversible TE.


  • Antimitotic drugs used in cancer or as an immunosuppressive can produce an anagen effluvium (acute loss of 80 % scalp hair) and at lower dose can induce a TE.


  • Angiotensin-converting enzyme inhibitors (captopril and enalapril) can induce TE. The mechanism appears to be binding of zinc, and is reversible with zinc supplements.


  • B-blockers (such as systemic and topical ophthalmologic proparanol, and metroprolol) can induce a chronic TE and diffuse alopecia.


  • Estrogen antagonist (such as tamoxifen, SERMS [selected estrogen receptor modifiers], and botanical phytoestrogens) can induce a TE and diffuse alopecia. These are estrogen competitive receptor inhibitors that inhibit estrogen action on the dermal papilla.


  • Heavy metals such as gold have induced severe alopecia.


  • Hypervitaminosis A can induce alopecia and TE. Vitamin A derivatives to monitor include mega multivitamins, vitamin A supplements, and the oral retinoids.


  • Minoxidil given orally can induce hirsutism, while when applied topically, it can initiate a TE which usually resolves in several months.


  • Statins to reduce cholesterol (such as clofibrfate, triparanol, and cholestyramine) can produce TE which can be dose-related.

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Nov 20, 2016 | Posted by in PHARMACY | Comments Off on Drug Eruptions of the Scalp

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