Antihistaminic Agents Research Articles

Novel Piperazine Derivatives as Potent Antihistamine, Anti-Inflammatory, and Anticancer Agents, their Synthesis and Characterization.

In this study, a series of novel piperazine derivatives were synthesised with high-to-good yields, and their structural analogies were confirmed using FTIR, 1H-NMR, and LC-MS techniques. The synthesised compounds were evaluated for antioxidant and antimicrobial activities. Among the four synthesised piperazine derivatives, compound PD-2 exhibited relatively good antioxidant activity, with an IC50 value of 2.396 μg/mL, while the other three derivatives showed moderate to low antioxidant activity. Furthermore, compound PD-2 displayed antimicrobial activity against Pseudomonas aeruginosa, a gram-negative bacterium, and Candida albicans, a fungus. However, all four compounds showed strong resistance against grampositive bacteria, Staphylococcus aureus. Additionally, compound PD-1 exhibited significant antihistamine activity, eliciting an 18.22% reduction in histamine levels. Both PD-1 and PD-2 demonstrated noteworthy anti-inflammatory activity in a dosedependent manner (5-10 μM), leading to the inhibition of nitrite production up to 39.42% and 33.7% at higher concentrations (10 μM) and inhibition of tumour necrosis factor-alpha (TNF-α) generation up to 56.97% and 44.73% at 10 μM, respectively. Additionally, both novel molecules PD-1 and PD-2 effectively restrained the growth of HepG2 cells in a manner that is dependent on the dosage up to 55.44% and 90.45% at the highest concentrations (100 μg/mL), respectively. These findings substantiate the rationale for further investigation into the novel series of persuasive piperazine analogues as potential agents with anti-inflammatory, antihistamine and anticancer properties.

Results of Observational Study and Integration of Epinastine 0,05% in Treatment Algorythms of Patients with Seasonal Allergic Conjunctivitis

Objective. To assess tolerability and the time of onset of clinical effect of dual­-action antihistamine agents — Epinepta® (epinastine 0.05 %) and olopatadine 0.1 % in patients with seasonal allergic conjunctivitis (SAC).Subjects and methods. This was a prospective multicenter observational study. One hundred fifty patients with SAC (n = 150) were included into the study and divided into two groups (n = 75) in each. Patients in group 1 received epinastine 0.05 %, while patients into group 2 received olopatadine 0.1 %. Evaluation of clinical symptoms severity was performed using itching scale, hyperemia Efrone scale, eyelid swelling scale, lacrimation P. Munk scale, Shirmer test and Norn probe. Patients and healthcare providers satisfaction rate was assessed by Likert scale, patients self-­control diary that helped to assess dry eye severity symptoms. Treatment period lasted 14 days.Results. Seasonal allergic conjunctivitis treatment with epinastine 0.05 % or olopatadine 0.1 % was equally effective. However epinastine 0.05 % was causing dry eye symptoms in lesser degree than olopatadine 0.1 %. These results refer to all parameters assessed by patients’ self­-control diary — itching, discomfort, burning, eye blockage feeling.Conclusion. The study evaluated epinastine 0.05 % advantages compared to olopatadine 0.1 % in tear film preservation and causing less pronounced symptoms of dry eye in patients with acute seasonal allergic conjunctivitis. Monotherapy of seasonal allergic conjunctivitis with epinastine 0.05 % demonstrated high efficacy and lead to SAC clinical manifestations regress. Epinastine 0.05 % is recommended as a first line treatment of SAC.

Edible Herbal Medicines as an Alternative to Common Medication for Sleep Disorders: A Review Article.

Insomnia is repeated difficulty in falling asleep, maintaining sleep, or experiencing lowquality sleep, resulting in some form of daytime disturbance. Sleeping disorders cause daytime fatigue, mental confusion, and over-sensitivity due to insufficient recovery from a sound sleep. There are some drugs, such as benzodiazepines and anti-histaminic agents, which help to sleep induction and insomnia cure. However, the prolonged administration is unsuitable because of tolerance and dependence. Therefore, the researchers attempt to find new medicines with lesser adverse effects. Natural products have always been good sources for developing new therapeutics for managing diseases such as cancer, cardiovascular disease, diabetes, insomnia, and liver and renal problems. Ample research has justified the acceptable reason and relevance of the use of these herbs in the treatment of insomnia. It is worth noting that in this study, we looked into various Persian herbs in a clinical trial and in vivo to treat insomnia, such as Artemisia annua, Salvia reuterana, Viola tricolor, Passiflora incarnata, lettuce, and Capparis spinose. According to research, herb extracts and fractions, particularly n-butanol fractions with non-polar agents, impact the benzodiazepine receptors and have hypnotic properties. Also, alkaloids, glycosides, flavonoids, saponins, and tannins in practically every plant are mentioned making them the popular natural compounds to help with sleep disorders and promote calmness.

Structural, spectral analysis, reactivity, topological and pharmacological investigations on an antihistamine agent

In this work, quantum computational techniques have been applied to the title compound (Methyl [2-(pyridin-3-yl) ethyl] amine) for insights into structural, vibrational, and electronic spectral features and chemical reactivity. The observed vibrational spectra in solid-phase have been compared with the theoretical one (DFT together with B3LYP /6–311++G (d, p). For the understanding of intra-molecular hyper conjugative interactions, a natural bond orbital (NBO) study was carried out. Nonlinear optical (polarizabilities) calculations have been performed. The molecule's bioactivity is confirmed by the frontier molecular orbital energy gap, and information regarding intra- and inter-non-covalent interactions is provided by non-covalent bond interaction (NCI) analysis. Molecular electrostatic potential (MEP) can identify a molecule's electrophilic and nucleophilic areas, and it can explain a molecule's chemical implications using electron localization function (ELF). The compound's reactive sites were examined using the Fukui function computations, and the molecule's reactivity is defined by its chemical descriptors. The bioactivity of a molecule is supported by molecular docking using the Histamine 1 receptors 3RZE and 7DFL protein, and drug likeness factors were computed to understand the biological properties of MP3EA.

Medicinal chemistry of benzimidazole, a versatile pharmacophore

Benzimidazole is a versatile moiety and has significant role in medicine and medicinal chemistry. The Benzimidazole moiety since discovered has been used in variety of medicine discovery in allopathic medicine. Some alkaloids used as alternative and complimentary medicines also contain benzimidazole. The pharmacophoric property of the moiety makes it versatile to be used as anti- ulcer, anti-helminthic, anti-bacterial, antiviral, and anti-histaminic agent. Here in this review the significant medicinal uses of benzimidazole moiety have been outlined.

Ayurvedic Management of Vicharchika vis-à-vis Atopic Dermatitis: A Case Report

In this fast-paced developing world, regular day-to-day activities like diet and sleep are neglected, leading to various skin disorders (Kushtha). Kushtha is a generalised term used for all skin diseases in Ayurveda. It is mainly divided into two types: Maha kushtha and Kshudra kushtha. Vicharchika is a type of Kshudra kushtha characterised by symptoms like blackish discolouration (Shyava varnata), vesicles (Pidika), discharge (Strava), and itching (Kandu), which can be correlated to atopic dermatitis/eczema. There is no adequate treatment to cure the root cause in contemporary medicine other than topical steroids and antihistaminic agents. The main treatment protocol according to Ayurveda involves the use of both purification (Shodhana) and palliative treatment (Shaman chikitsa). A 21-year-old female patient presented with small blackish papules on both upper limbs, oosing, and itching on the lesions. She was given medication for both internal use and external application, resulting in significant improvement in symptoms. The patches resolved, and the discharge, itching, and vesicles disappeared.

Dithiocarbamate-based novel anti-histaminic agents: synthesis, characterization, crystal structure and thermal study.

A new N-(4-fluorobenzyl) N-(pyridin-2-ylmethyl) dithiocarbamate ligand (fbpm) having structural similarity to clinically approved antihistaminic drugs (viz. pheniramine, chlorpheniramine, and brompheniramine) and its four metal complexes [Co(fbpm)3] (1), [Ni(fbpm)2] (2), [Cu(fbpm)2] (3), and [Zn(fbpm)2] (4) were successfully synthesized and characterized by various techniques i.e. elemental analysis, FT-IR spectroscopy, HR-MS, NMR spectroscopy, and absorption and emission spectroscopy. Furthermore, complexes 1 and 2 were characterized by single crystal X-ray diffraction. Complex 1 adopts distorted octahedral geometry around the Co(III) center while complex 2 adopts distorted square planar geometry around the Zn(II) center. X-ray data also showed various weak intermolecular C-H⋯F and C-H⋯N hydrogen bonding interactions leading to supramolecular architectures in complexes 1 and 2. The thermal decomposition study of complexes 1-4 analyzed by TGA shows that they are thermally stable up to 150 °C and also gives strong evidence for the formation of respective metal sulfides at higher temperatures. The antihistaminic activity of the ligand (fbpm) and its complexes 1-4 was examined against clonidine and haloperidol-induced catalepsy in Swiss albino mice of either gender in an in vivo animal model. The result shows that these synthesized compounds have antihistaminic potential to inhibit clonidine-induced catalepsy and may be targeted for different allergic conditions. Complex 3 showed maximum reduction in clonidine-induced catalepsy after 180 minutes of treatment when compared with the induced control.

Comparative efficacy of combined antihistamine and montelukast therapy in adult patients with atopic dermatitis.

Atopic dermatitis (AD) is one of the most common chronic skin conditions affecting about 20% of children and 5% of adults. However, the studies assessing novel therapies for AD have been focused mainly on paediatric patients and only few studies have involved adult participants. To compare the treatment outcomes between the antihistamine monotherapy and combined intervention with an antihistamine agent and a cysteinyl leukotriene receptor antagonist in adult patients with atopic dermatitis. Patients were randomized into two groups to receive 5 mg oral desloratadine or the combined therapy with 5 mg oral desloratadine and 10 mg montelukast. Both groups were also administered topical treatment using the same protocol (topical Elocon and moisturizer). To estimate the efficacy of the implemented therapy methods, different skin health scores (SCORAD, GISS, EASI, PPNRS and DLQI) and skin functional assessment outcomes (corneometry, pH and transepidermal water loss) were evaluated before and after the treatment. Significant differences were revealed in compared measurement results for scales of the Extent and Severity of Eczema assessment, Global Individual Signs Score, Eczema Area and Severity Index, Pruritus Numerical Rating Scale, Dermatology Life Quality Index and Skin Functional Properties (p > 0.05). Comparison of data presenting the therapy outcomes in two groups showed that administration of the combined therapy was significantly more effective compared to the antihistamine monotherapy. The results revealed considerable efficacy of the combined therapy reinforced by the use of cysteinyl leukotriene receptor antagonist, montelukast.

A Rare Case of Angioedema Face due to Fish Allergy - A Case Report

Angioedema is defined by World Allergy Organization as a transient swelling of the skin or submucosal surface due to increased vascular permeability of small venules. Most common etiologies include IgE-mediated allergic reactions (to food, drug, or environmental triggers), nonsteroidal anti-inflammatory drug (NSAID), and chemically induced histamine release (most commonly opiates, highly cationic antibiotics, and muscle relaxants). Recent publications show a global incidence of anaphylaxis between 50 and 112 episodes per 100 000 person-years while the estimated lifetime prevalence is 0.3-5.1%. Timely intubation and administration of steroids/ antihistaminic agents will prevent a catastrophic cannot intubate cannot ventilate situation. In small, resource limited environment of a field hospital which may be compared to a rural setting in India managing such emergencies is challenging. If available in a case of anticipated difficult airway like this difficult airway cart must contain a whole armamentarium of airway adjuncts and gadgets. History of consumption of fish (Nile Perch) a rare form of allergen causing airway and breathing issues leading to timely intubation saved the life of patient.

The Influence of Seasonal Allergic Conjunctivitis and Its Treatment on Choroidal Vascular Index

Purpose: To evaluate the the effects of seasonal allergic counjunctivitis (AC) and its treatment upon choroidal structure such as choroidal thickness (ChT) and choroidal vascular index (CVI) through the use of topical antihistamine agents. Methods. The 60 eyes of 30 patients were included in the AC group. Another 30 patients were included in the control group. The choroid was imaged by using enhanced depth imaging optical coherence tomography (EDI-OCT) instrument without pupillary dilation. ChT was defined as the area between the outer hyperreflective border of the RPE and the sclerochoroidal border at the fovea, 750 µm temporal to the fovea and 750 µm nasal to the fovea. Image J was used to measure CVI. With the images obtained from EDI-OCT, the total choroidal area (TCA), luminal area (LA), stromal area (SA), and CVI were calculated using the binarization method. Results. The mean ChT value in the AC group was 358.5 ± 93.8 µm at baseline and 356.8 ± 86.6 µm following 1 month of treatment. Meanwhile, the mean ChT in the control group was 316.6 ± 60.7 µm. The mean CVI value was 66.65 ± 2.98 in the control group, 70.75 ± 3.26 in the AC group at baseline, and 69.50 ± 3.17 following 1 month of treatment. Statistically significant difference was tracked between control and AC group (p = 0.028) and control group and posttreatment values (p=0,031). There were no statistically significant difference between initial AC treatment values and posttreatment values for all of the measurements. Conclusion. ChT and CVI can increase in patients with AC due to inflammation and increased vascular permeability. Although symptoms and signs related to AC may disappear after the treatment, effects in the choroid do not immediately normalize.

Preparation of Diatomite-Chitosan Composites for Loading and Release of Diphenhydramine HCl

Diatomite ores have great potential as an adsorbent and drug carrier system due to their natural abundance, biocompatible, and high surface area. In the first stage of this study, raw diatomite ore was enriched by grinding and calcination processes. As a result of the enrichment process, the surface area was found to be 21.7 m2/g for raw diatomite and 75.1 m2/g for calcined diatomite. Subsequently, a series of diatomite-chitosan composites with different composition ratios were produced. Then, the loading (adsorption) performances of diphenhydramine hydrochloride (DPH), an antihistaminic agent, were investigated on the prepared composites. The highest loading capacity was 91.1 mg/g, and the lowest loading capacity was 48.8 mg/g in the prepared DPH-loaded formulations. After DPH loading studies, DPH release profiles (desorption) and release kinetics from composites were investigated. As a result of in vitro release studies, it was observed that formulations containing chitosan polymer had slower release than chitosan free formulations. It was determined that the formulations had a cumulative release in the 70-90% range, and the release processes were completed between 45-90 minutes. In vitro release profiles of the prepared formulations were compatible with Higuchi kinetics.

Electro‐elucidation and quantification of olopatadine hydrochloride in bulk form and eye drops using modification free glassy carbon electrode with its development by different electrolytes and surfactants

AbstractThe electro‐oxidation pathway of olopatadine hydrochloride which is used in eye drops as antihistaminic agent was proposed and discussed in detail as the first time using different voltammetry methods at the modification free glassy carbon electrode surface. The oxidation process of olopatadine hydrochloride based on the presence of electro‐active tertiary amine group was irreversible. The dissociation constants were attained by the dependence of peak current and potential on the pH values. Some kinetic parameters were also estimated. Depending on the oxidation of olopatadine hydrochloride in citrate buffer (pH 5.5; 0.1 M) and sodium dodecyl sulfate (3×10−5 M) as supporting electrolyte and a modifier, respectively, sensitive, simple, accurate and inexpensive a novel square wave voltammetry method was achieved. The method was validated for linearity, precision, accuracy, ruggedness, specificity and stability. Limit of detection of 9×10−7 M in bulk form was attained. The characterized method was successfully used for routine analysis of olopatadine hydrochloride in pharmaceutical eye drops (Olohistine® and olopalite). No electroactive interferences from the inactive ingredients present in eye drops were noticed. So the proposed method does not necessitate any extraction step preceding the drug analysis. Also, the obtained data of the calibration curve and standard addition methods were compared statistically with a reported spectrophotometrically method showing no differences between them with respect to accuracy and precision, what proved the reproducibility, suitability and reliability of the described voltammetric method for assay of olopatadine hydrochloride in its formulation.

A Review Exploring Therapeutic Effect of 1,3,4-Oxadiazole Compounds

There are many synthesized compounds that contain the five-membered aromatic ring 1,3,4-oxadiazole. It is advantageous for 1,3,4-oxadiazole derivatives to have effective binding with various enzymes and receptors in biological systems through numerous weak interactions, eliciting a variety of bioactivities. This is made possible by the peculiar structural feature of the 1,3,4-oxadiazole ring with pyridine type of nitrogen atom. For scientists, research on the creation of derivatives based on 1,3,4-oxadiazole has become an intriguing subject. Numerous 1,3,4-oxadiazole-based compounds with strong therapeutic potencies are widely utilized to treat a variety of illnesses, which has a significant positive impact on development. In the entire spectrum of medicinal chemistry, including anticancer, antifungal, antibacterial, antitubercular, anti-inflammatory, antineuropathic, antihypertensive, antihistaminic, antiparasitic, antiobesity, antiviral, and other therapeutic agents, this work provides a systematic and thorough review. It is anticipated that this evaluation will be very beneficial for fresh ideas in the search for logical designs for the creation of more effective and less harmful 1,3,4-oxadiazole-based pharmaceutical medicines.
 Keywords: 1,3,4-oxadiazole; anticancer; antimicrobial; antioxidant; isoforms; therapeutic worth.

General approach to dry cough

Dry cough is a common health problem and upper airway cough syndrome, asthma and gastroesophageal reflux disease are the most common causes of dry cough in adults. Diagnostic approach and algorithms are defined according to the American Academy of Chest Diseases cough guideline updated in 2006.The initial evaluation should start with history taking, physical examination, radiologic and spirometric assessment. Antihistaminic and decongestant agent combinations, inhaled corticosteroid and bronchodilator combinations, leukotriene receptor antagonists, and when necessary oral steroids are used in the treatment depending on the etiology. Treatments based on etiology and if needed evaluation with further tests are essential.

Structural, Quantum Chemical, Spectroscopic (UV, FT-IR, FT-Raman and NMR) and Molecular Docking Studies of Diphenylpyraline Hydrochloride as Antihistaminic Drug

Diphenylpyraline hydrochloride, chemically known as 4-benzhydryloxy-1-methypiperidine hydrochloride is a first-generation antihistaminic drug that produces therapeutic antiallergic effects by binding to histamine H1 -receptors. The molecular structural and electronic properties of title compound have been computed at DFT/TD-DFT method with B3LYP/6-311++G(d,p) level. The theoretical spectral data has been compared with experimental ones, showing good agreement. The atomic charges, molecular electrostaitc potential (MEP), the natural bond orbitals (NBOs), the natural hybrid orbital (NHOs), the non-lilear optical (NLO) properties, the vibrational (IR and Raman) frequencies, UV-vis absorption wavelenghts and nuclear magnetic resonance (NMR) chemical shifts of diphenylpyraline hydrochloride have been investigated. The potential energy distribution (PED) of title compound was performed using the VEDA program and these values were compared with the experimental FT-IR and FT-Raman vibrational frequencies. Moreover, molecular docking studies have been performed between the 3RZE and 7DFL target proteins and the title compound. Docking results revealed that the title compound can be designed as potential antihistaminic agent.

P19-derived neuronal cells express H1, H2, and H3 histamine receptors: a biopharmaceutical approach to evaluate antihistamine agents

Histamine is a biogenic amine implicated in various biological and pathological processes. Convenient cellular models are needed to screen and develop new antihistamine agents. This report aimed to characterize the response of neurons differentiated from mouse P19 embryonal carcinoma cells to histamine treatment, and to investigate the modulation of this response by antihistamine drugs, vegetal diamine oxidase, and catalase. The exposure of P19 neurons to histamine reduced cell viability to 65% maximally. This effect involves specific histamine receptors, since it was prevented by treatment with desloratadine and cimetidine, respectively, H1 and H2 antagonists, but not by the H3 antagonist ciproxifan. RT-PCR analysis showed that P19 neurons express H1 and H2 receptors, and the H3 receptor, although it seemed not involved in the histamine effect on these cells. The H4 receptor was not expressed. H1 and H2 antagonists as well as vegetal diamine oxidase diminished the intracellular Ca2+ mobilization triggered by histamine. The treatment with vegetal diamine oxidase or catalase protected against mortality and a significant reduction of H2O2 level, generated from the cells under the histamine action, was found upon treatments with desloratadine, cimetidine, vegetal diamine oxidase, or catalase. Overall, the results indicate the expression of functional histamine receptors and open the possibility of using P19 neurons as model system to study the roles of histamine and related drugs in neuronal pathogenesis. This model is less expensive to operate and can be easily implemented by current laboratories of analysis and by Contract Research Organizations.

Repurposing ketotifen as a therapeutic strategy for neuroendocrine prostate cancer by targeting the IL-6/STAT3 pathway.

Neuroendocrine prostate cancer (NEPC), a highly aggressive subtype of prostate cancer displaying resistance to hormone therapy, presents a poor prognosis and limited therapeutic options. Here, we aimed to find novel medication therapies for NEPC and explore the underlying mechanism. A high-throughput drug screening utilizing an FDA-approved drug library was performed and ketotifen, an antihistamine agent, was identified as a potential therapeutic candidate for NEPC. The whole-transcriptome sequencing analysis was conducted to explore mechanism of ketotifen inhibitory in NEPC. Multiple cell biology and biochemistry experiments were performed to confirm the inhibitory effect of ketotifen in vitro. A spontaneous NEPC mice model (PBCre4:Ptenf/f;Trp53f/f;Rb1f/f)was used to reveal the inhibitory effect of ketotifen in vivo. Our in vitro experiments demonstrated that ketotifen effectively suppressed neuroendocrine differentiation, reduced cell viability, and reversed the lineage switch via targeting the IL-6/STAT3 pathway. Our in vivo results showed that ketotifen significantly prolonged overall survival and reduced the risk of distant metastases in NEPC mice model. Our findings repurpose ketotifen for antitumor applications and endorse its clinical development for NEPC therapy, offering a novel and promising therapeutic strategy for this formidable cancer subtype.

Pediatric Conjunctivitis: A Review of Clinical Manifestations, Diagnosis, and Management.

Conjunctivitis is a common pediatric problem and is broadly divided into infectious and non-infectious etiologies. Bacterial conjunctivitis makes up the majority of cases in children and often presents with purulent discharge and mattering of the eyelids. Treatment is supportive with an individual approach to antibiotic use in uncomplicated cases since it may shorten symptom duration, but is not without risks. Viral conjunctivitis is the other infectious cause and is primarily caused by adenovirus, with a burning, gritty feeling and watery discharge. Treatment is supportive. Allergic conjunctivitis is largely seasonal and presents with bilateral itching and watery discharge. Treatment can include topical lubricants, topical antihistamine agents, or systemic antihistamines. Other causes of conjunctivitis include foreign bodies and non-allergic environmental causes. Contact lens wearers should always be treated for bacterial conjunctivitis and referred to evaluate for corneal ulcers. Neonatal conjunctivitis requires special care with unique pathogens and considerations. This review covers essential information for the primary care pediatric provider as they assess cases of conjunctivitis.

Biological screening of a unique drug library targeting MRGPRX2.

Allergic drug reaction or drug allergy is an immunologically mediated drug hypersensitivity reaction (DHR). G-protein coupled receptors (GPCRs) are common drug targets and communicate extracellular signals that initiate cellular responses. Recent evidence shows that GPCR MRGPRX2 is of major importance in IgE-independent pseudo-allergic DHRs based on the suspected interactions between many FDA-approved peptidergic compounds and MRGPRX2. Our aim was to uncover novel MRGPRX2-selective and -potent agonists as drug candidates responsible for clinical features of pseudo-allergic DHRs. We conducted a primary high-throughput screening (HTS), coupled with mutagenesis targeting the MRGPRX2 N62S mutation, on a panel of 3,456 library compounds. We discovered pharmacologically active hit compounds as agonists of the MRGPRX2 protein according to high degrees of potency evaluated by the calcium response and validated by the degranulation assay. Using the molecular tool Forge, we also characterized the structure-activity relationship shared by identified hit compounds. The alternative allele of single nucleotide polymorphism rs10833049 (N62S) in MRGPRX2 demonstrated loss-of-function property in response to substance P and antineoplastic agent daunorubicin hydrochloride. We applied a unique assay system targeting the N62S mutation to the HTS and identified 84 MRGPRX2-selective active hit compounds representing diverse classes according to primary drug indications. The top five highly represented groups included fluoroquinolone and non-fluoroquinolone antibiotics; antidepressive/antipsychotic; antihistaminic and antineoplastic agents. We classified hit compounds into 14 clusters representing a variety of chemical and drug classes beyond those reported, such as opioids, neuromuscular blocking agents, and fluoroquinolones. We further demonstrated MRGPRX2-dependent degranulation in the human mast cell line LAD2 cells induced by three novel agonists representing the non-fluoroquinolone antibiotics (bacitracin A), anti-allergic agents (brompheniramine maleate) and tyrosine-kinase inhibitors (imatinib mesylate). Our findings could facilitate the development of interventions for personalized prevention and treatment of DHRs, as well as future pharmacogenetic investigations of MRGPRX2 in relevant disease cohorts.

Lichenoid eruption due to antitubercular drugs: a case report

Adverse drug reactions can be predictable or unpredictable. Regardless, they must be communicated to patients to improve the quality of healthcare. According to the World Health Organization (WHO), in the year 2020, tuberculosis was the thirteenth leading cause of death worldwide. For the clinician who commonly encounters tuberculosis, the effectiveness of antitubercular drugs such as rifampicin, isoniazid, pyrazinamide and ethambutol are complicated by the severity of adverse reactions. This requires the physicians to weigh both the benefits and the risks of using these medications and to choose appropriate management strategies. Here, we report a case of lichenoid drug eruption related to antitubercular drugs in an elderly gentleman diagnosed to have extrapulmonary tuberculosis. The skin disorder presented with thickness and hyperpigmentation of the skin. The exact offending drug could not be conclusively identified but therapy was continued under the cover of a topical steroid and an antihistamine agent. The medical reporting of such cases is essential to identify one of several cutaneous adverse reactions seen with antitubercular drugs. Furthermore, it aids in alerting health care professionals and the public of the potential undesirable effects of these drugs.