Bullous Pemphigoid-like Skin Eruption during Treatment with Rivaroxaban: A Clinical Case Study

Eur J Case Rep Intern Med. 2018 Mar 21;5(3):000724. doi: 10.12890/2018_000724. eCollection 2018.

Abstract

Little has been documented about hypersensitivity reactions caused by treatment with rivaroxaban. This paper reports a bullous pemphigoid-like skin eruption that occurred in a 76-year-old female patient during rivaroxaban treatment. This case highlights the vigilance required by healthcare workers in recognising potential adverse effects of newly marketed drugs and in making medication changes when necessary. A bullous pemphigoid-like eruption due to treatment with rivaroxaban has not, to the best of the Authors' knowledge, been reported previously in the literature.

Learning points: Rivaroxaban can cause a bullous eruption apparently similar to epithelial toxic necrolysis (or to Stevens-Johnson syndrome).There is an apparent similarity between skin adverse events caused by the different anticoagulants.The anticoagulant responsible for the skin side-effects can be identified on clinical grounds by the correct differential diagnosis.

Keywords: Rivaroxaban; bullous pemphigoid-like; cutaneous drug eruptions.