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Year : 2022  |  Volume : 67  |  Issue : 3  |  Page : 296-297
Bilateral palmoplantar desquamation secondary to colchicine treatment of pericarditis

1 Department of Cardiology, St. Luke's University Hospital, 801 Ostrum St. Fountain Hill, PA, USA
2 Department of Research, St. Luke's University Hospital, 801 Ostrum St. Fountain Hill, PA, USA

Date of Web Publication22-Sep-2022

Correspondence Address:
Matthew Krinock
Department of Cardiology, St. Luke's University Hospital, 801 Ostrum St. Fountain Hill, PA
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijd.ijd_437_20

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How to cite this article:
Nanda S, Yellapu V, Krinock M. Bilateral palmoplantar desquamation secondary to colchicine treatment of pericarditis. Indian J Dermatol 2022;67:296-7

How to cite this URL:
Nanda S, Yellapu V, Krinock M. Bilateral palmoplantar desquamation secondary to colchicine treatment of pericarditis. Indian J Dermatol [serial online] 2022 [cited 2022 Sep 30];67:296-7. Available from:


Colchicine is an anti-mitotic, anti-inflammatory drug that prevents microtubule formation, actively degrades microtubules, and affects inflammatory mediators like interleukin-8/interleukin-18.[1],[2] It is used to treat gout, familial Mediterranean fever (FMF), and pericarditis.[3] The common side effects are diarrhea, abdominal pain, nausea, and vomiting. An overdose can cause lactic acidosis, rhabdomyolysis, acute kidney injury, and epidermal necrosis.[1],[3] Alopecia and rash have been reported in <5% of the patients.[2] Palmoplantar desquamation, to our knowledge, has never been reported.

Our patient is a 59-year-old male with a history of obesity, diabetes-mellitus, hyperlipidemia, and paroxysmal atrial fibrillation, on medical treatment with apixaban, dofetilide, metoprolol, rosuvastatin, and metformin, who underwent radiofrequency ablation for paroxysmal atrial fibrillation. Post-ablation, he was started on colchicine for pericarditis. Within 3 days, he developed bilateral palmoplantar desquamation [Figure 1]. This resolved within 10 days of discontinuation of colchicine. A subsequent Naranjo scale performed revealed a score of 6, indicating a probable adverse drug reaction (ADR). A re-challenge was not done as the patient was not willing to undergo it.
Figure 1: A pattern of desquamation is seen on the patient's palms and soles. It is diffuse without any pruritic or erythematous changes.

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Palmoplantar desquamation is seen in many infectious diseases including the hand-foot-mouth disease, Sarcoptes scabiei, tinea manuum, and pedis.[4],[5],[6] It also is seen in rheumatological diseases, including Kawasaki's disease, scarlet fever, systemic lupus, adult-onset Still's disease, acral skin peeling syndrome, keratolysis exfoliative, as well as more common dermatological conditions such as atopic dermatitis.[4],[6] Additionally, reports of the following drugs can cause it. Arsenic (used in some acute promyelocytic leukemia chemotherapy formulations), tyrosine-kinase inhibitors, acitretin, chloroquine, diltiazem, hydroxyurea, sirolimus, and tretinoin.[3],[5],[6]

The chemotherapeutic agents, such as tyrosine kinase inhibitors have also been reported to cause a similar but distinct hand desquamating reaction called the hand-foot syndrome (HFS) which is typically more severe.[6] Drug-induced desquamation usually resolves after 1–2 weeks of discontinuation of the inciting medication.

Our case highlights a new reaction to colchicine that is important for clinicians to recognize to educate patients before initiating therapy.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Arroyo MP, Sanders S, Yee H, Schwartz D, Kamino H, Strober BE. Toxic epidermal necrolysis-like reaction secondary to colchicine overdose. Br J Dermatol 2004;150:581-8.  Back to cited text no. 1
Yan BP, Tan G-M. What's old is new again – A review of the current evidence of colchicine in cardiovascular medicine. Curr Cardiol Rev 2016;13:130-8.  Back to cited text no. 2
Litt J, Shear N. Litt's Drug Eruption and Reaction Manual. 26th ed. Boca Raton: CRC Press; 2019.  Back to cited text no. 3
Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al. Fitzpatrick's Dermatology. 9th ed. McGraw-Hill; 2019.  Back to cited text no. 4
Nair P, Patel T. Palmoplantar exfoliation due to chloroquine. Indian J Pharmacol 2017;49:205-7.  Back to cited text no. 5
[PUBMED]  [Full text]  
Liu LS, McNiff JM, Colegio OR. Palmoplantar peeling secondary to sirolimus therapy. Am J Transplant 2014;14:221-5.  Back to cited text no. 6


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