Lichenoid and subacute cutaneous lupus erythematosus-like dermatitis associated with antihistamine therapy

The authors report the occurrence of lichenoid and/or subacute lupus erythe matosus-like eruptions in a group of patients receiving agents with antihis taminic properties. In 1 of the patients the eruption clinically resembled lichen planus, while in 5 patients the eruption resembled subacute cutaneou s lupus erythematosus (SCLE). At a light microscopic level all cases showed a lichenoid dermatitis and in 4 cases the lesions were interpreted as repr esenting subacute lupus-like eruptions by virtue of the presence of alterna ting cell poor and lichenoid interface dermatitis, suprabasilar lymphocytos is around degenerating keratinocytes, and dermal mucinosis. Despite the res emblance at a clinical and light microscopic level to SCLE, anti-Ro seropos itivity could not be established in any of the cases. One case, however, di d demonstrate antihistone antibodies in concert with a high antinuclear ant ibody titer. A causal association was implicated by virtue of lesional reso lution following drug withdrawal. The association of cutaneous eruptions re sembling SCLE with antihistamine intake is seemingly a novel one. The possi ble pathogenetic basis of the eruptions is discussed.