Hand-foot lesion in old age asthmatic women – American Journal of Biomedicine

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Jie Zhang ¹, Miao H Stetsenko^*

∗Correspondence author e-mail: stetsenkoh@libero.it: ¹Allergy Therapeutics Italia, Milano, Italy

Abstract

A case study of a fifty-six-year-old woman diagnosed with asthma is presented. Her medications included inhaled corticosteroids, long-acting beta agonists, 2-adrenergic receptor agonists, and montelukast. After a month of treatment with fluticasone propionate, a hand-foot lesion occurred. The lesion in the fuzzy area of the foot and palm is recurrent and itchy. A literature search found fluticasone propionate linked to contact dermatitis. Patch testing confirmed a hypersensitivity reaction to fluticasone propionate. Fluticasone propionate was withdrawn, and alternative medications were prescribed. The paper discusses the need for allergy testing in patients with similar side effects and highlights the adverse effects of fluticasone propionate. A fifty-six-year-old woman diagnosed with asthma twenty years ago presented to the chest clinic with complaints of recurrent wheezing and breathlessness for the past three months. Her medications included: inhaled corticosteroids: fluticasone propionate (250 mcg, 2 puffs, twice daily)/seretide (250 mcg, 2 puffs, twice daily); long-acting beta agonists: salmeterol (50 mcg, 2 puffs, twice daily); 2-adrenergic receptor agonists: formoterol (6 mcg, 1 pump, twice daily); and montelukast (10 mg, once at night). During treatment with fluticasone propionate for a month, the patient noticed a reddish round lesion in the fuzzy area of the right foot and palm. The lesion was recurrent and itchy, with papules that ultimately led to desertification. The basal site had a blush after removing a scab. Associated lesions were found on the left side, indicating the lesion was not a fungal infection. The lesion occurred in the fuzzy area, not in the usual places like the fingers, wrists, or neck. The lesion cleared for six months after stopping the medication. A search of PubMed and Google Scholar was conducted for "fluticasone propionate and hand-foot lesion." Methylprednisolone aceponate and other glucocorticoids were temporarily linked to cutaneous granuloma annulare. Fluticasone propionate was searched by "hand-foot lesion and fluticasone," which returned zero results. A search by "hand-foot lesion and propionate" also returned zero results. However, "fluticasone and contact dermatitis" returned seven results.

Keywords: Painful lesion; Aciclovir; Hand and foot; Erythematous papules; Entro-virus

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