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Case Reports
. 2022 Mar 25:2022:1461145.
doi: 10.1155/2022/1461145. eCollection 2022.

Interstitial Granulomatous Drug Reaction to Ustekinumab

A Walker  1 , J S Westerdahl  1 , J Zussman  2 , J Mathis  2
Affiliations
Case Reports

Interstitial Granulomatous Drug Reaction to Ustekinumab

A Walker et al. Case Rep Dermatol Med. .

Abstract

Interstitial granulomatous drug reaction (IGDR) is a distinct inflammatory process that often presents as annular, violaceous plaques distributed on the extremities, proximal trunk, and intertriginous areas. The list of drugs implicated for inciting IGDR is growing, but most prominently includes ACE inhibitors, antihistamines, beta-blockers, antidepressants, and anticonvulsants. Ustekinumab is a human monoclonal antibody that targets inflammatory cytokines IL-12 and IL-23 and has been have shown to be effective in treating IGDR. However, we present a case that suggests ustekinumab can also act as an inciting agent for IGDR.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Pink papules coalescing into plaques on the left forearm. The rash extends into the posterior arm and is present bilaterally.
Figure 2
Figure 2
Histopathology with H&E demonstrating (a) epidermal acanthosis and mild spongiosis at 100X. There is dense perivascular inflammation, and interstitial histiocytes are noted at the edge of the specimen. (b) Histiocytes are seen between collagen bundles as well as scattered eosinophils, 400X.
See this image and copyright information in PMC

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