Key result
Switching to clopidogrel resolves rare ticagrelor-induced hypersensitivity rash involving palms and soles.
Why the study?
Increased use of ticagrelor necessitates awareness of uncommon adverse events such as hypersensitivity skin reactions, with limited published data and no consensus on management after such reactions.
Case Report (n=1)
No
Ticagrelor can cause rare hypersensitivity skin reactions that resolve upon switching to clopidogrel and initiating steroid/antihistamine therapy.
Answers are grounded in this paper and cite their sources.
Clinicians should remain vigilant for ticagrelor-induced eruptions; this rare case extends limited reports but is hypothesis-generating.
Currently, guidelines recommend ticagrelor over clopidogrel as part of dual antiplatelet therapy with aspirin in treating individuals with acute coronary syndrome. As there is an increased usage of ticagrelor, it is important to keep in mind uncommon adverse events, including hypersensitivity skin reactions. To date, only a few studies have been published regarding ticagrelor-induced skin eruptions. Additionally, there is no consensus on antiplatelet therapy management after a hypersensitivity reaction to antiplatelet agents. Hereinafter, we describe a case of an 81-year-old female who presents with a diffuse erythematous hypersensitivity eruption, including palms and soles, secondary to ticagrelor use. Ticagrelor transitioned to clopidogrel, and the patient was started on steroid taper with an antihistamine. The patient's rash progressively improved after the treatment. Our case demonstrates a rare adverse effect of ticagrelor, which needs prompt diagnosis and switching to one of the thienopyridines to prevent thrombosis.
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Akdogan et al. (2023) conducted a case report in Ticagrelor-induced hypersensitivity skin reaction (n=1). Ticagrelor was evaluated on Resolution of hypersensitivity rash. Ticagrelor induced a rare generalized erythematous hypersensitivity eruption involving the palms and soles, which progressively improved after switching to clopidogrel and initiating steroids.
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