Anti-hypertensive drugs, including
diuretics and beta-blocking drugs, belong to a group of
therapeutics used by about a fourth of the Danish population. As with
cytostatics,
antibiotics, and topical remedies, they rather frequently cause
adverse drug reactions (ADR) in the skin. No exact statistical information is available concerning the extent of such side effects. The information obtained by Danish National Board of Health's Committee on
Adverse Drug Reactions shows that 10-60% of ADR from
diuretics, beta-blocking agents, and
anti-hypertensive drugs are dermatological. The skin symptoms are not unique for any specific
drug. But certain symptoms occur more frequently than others.
Thiazides can give
vasculitis, a phototoxic/-allergic eruption,
erythema multiforme, or
eczema. The combination of
amiloride (5 mg) and
hydrochlorothiazide (50 mg) carries the highest number of recorded ADR; 59% of these are in the skin. Half of the skin ADR are phototoxic
eczema.
Furosemide may give
eczema,
purpura, a bullous eruption, or Steven-Johnson's syndrome in rare cases.
Methyldopa can induce eczematous eruptions on hands and feet, a
lichenoid eruption, a lupus erythematosus-like eruption, or
purpura.
Hydralazine may give lupus erythematosus-like eruptions,
eczema, or
urticaria. Non-specific beta-blocking drugs can induce a morbilliform
rash and may aggravate
psoriasis.
Captopril may induce
pruritus in up to 15% of the patients and skin eruptions in 2%. The most serious dermatological side effect,
exfoliative dermatitis, is very rarely seen following the use of
anti-hypertensive drugs or
diuretics.