{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:32:36Z","timestamp":1787070756079,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:p>Hypertension, a major global health burden affecting over one billion people worldwide, is primarily managed with pharmacological therapy. While effective for cardiovascular protection, antihypertensive drugs can cause under-recognized cutaneous adverse drug reactions (CADRs). This review summarizes CADRs associated with antihypertensive medications, including pathophysiology, clinical presentation, diagnosis, management, and prevention. A narrative review of PubMed (January 2001\u2013August 2025) was conducted to identify studies on CADRs linked to antihypertensive therapy, and observational studies, case reports, case series, and clinical trials were included. CADRs arise through immunologic (Types I\u2013IV hypersensitivity, most often Type IV) and non-immunologic mechanisms. Clinical presentations range from mild eruptions (maculopapular rash, photosensitivity, urticaria) to severe reactions such as Stevens\u2013Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Symptoms usually occur within weeks of initiation, though delayed reactions are possible. Diagnosis relies on detailed medication history, examination, and, in selected cases, histopathology, and resolution after drug withdrawal is a key diagnostic clue. Management involves discontinuing the offending agent, supportive care, and pharmacological interventions (e.g. corticosteroids, antihistamines). Preventive strategies include avoidance of reexposure, substitution with safer alternatives, and strict photoprotection. Antihypertensive medications can cause diverse CADRs with variable severity and clinical impact, and early recognition and prompt management are essential to minimize morbidity. Prospective studies with standardized definitions and pharmacogenomic approaches are needed to improve risk prediction and guide safer, individualized prescribing.<\/jats:p>","DOI":"10.4103\/jfmpc.jfmpc_1859_25","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T14:00:15Z","timestamp":1781791215000},"page":"1904-1910","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Cutaneous effects of antihypertensive drugs: A comprehensive narrative review of side effects, management, and prevention"],"prefix":"10.4103","volume":"15","author":[{"given":"Luluh Z.","family":"Aljaloud","sequence":"first","affiliation":[{"name":"College of Medicine, Hail University, Hail, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mashael T.","family":"Alanazi","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kadi S.","family":"Alsubaie","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammed Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sali F.","family":"Alharbi","sequence":"additional","affiliation":[{"name":"College of Medicine, Qassim University, Buraydah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharifa M.","family":"Aljalfan","sequence":"additional","affiliation":[{"name":"College of Medicine, King Khalid University, Abha, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah H.","family":"Alwadai","sequence":"additional","affiliation":[{"name":"College of Medicine, King Khalid University, Abha, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walaa M.","family":"Aleran","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Taibah University, Medina, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruaa","family":"Alharithy","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Security Forces Hospital, Riyadh, Saudi Arabia"},{"name":"College of Medicine, Princess Nourah Bint Abdul Rahman University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"R2-20260619","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.1016\/S0140-6736(18)32225-6","article-title":"Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017","volume":"392","year":"2018","journal-title":"Lancet Lond Engl"},{"key":"R3-20260619","doi-asserted-by":"crossref","first-page":"137","DOI":"10.4103\/ijdvl.IJDVL_992_16","article-title":"Antihypertensives in dermatology Part II-Cutaneous adverse reactions to antihypertensives","volume":"84","author":"Ranugha","year":"2018","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R4-20260619","first-page":"955","article-title":"Immunologic adverse reactions of \u03b2-blockers and the skin","volume":"18","author":"Tatu","year":"2019","journal-title":"Exp Ther Med"},{"key":"R5-20260619","doi-asserted-by":"crossref","DOI":"10.1177\/2152656718764139","article-title":"Amlodipine-induced angioedema: An unusual complication of a common medication","volume":"9","author":"Kuruvilla","year":"2018","journal-title":"Allergy Rhinol (Providence)"},{"key":"R6-20260619","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"R7-20260619","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.ad.2013.01.010","article-title":"Photosensitivity due to thiazides","volume":"105","author":"G\u00f3mez-Bernal","year":"2014","journal-title":"Actas Dermosifiliogr"},{"key":"R8-20260619","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1080\/000155501317140007","article-title":"Angiotensin-converting enzyme inhibitors as inducers of adverse cutaneous reactions","volume":"81","author":"Steckelings","year":"2001","journal-title":"Acta Derm Venereol"},{"key":"R9-20260619","doi-asserted-by":"crossref","first-page":"14","DOI":"10.5070\/D34580R7RS","article-title":"Letter: Photodistributed reticulated hyperpigmentation related to diltiazem","volume":"17","author":"Jaka","year":"2011","journal-title":"Dermatol Online J"},{"key":"R10-20260619","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1111\/phpp.12583","article-title":"Systemic drug photosensitivity-culprits, impact and investigation in 122 patients","volume":"36","author":"Alrashidi","year":"2020","journal-title":"Photodermatol Photoimmunol Photomed"},{"key":"R11-20260619","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1001\/archinternmed.2012.2754","article-title":"Antihypertensive drugs and lip cancer in non-Hispanic whites","volume":"172","author":"Friedman","year":"2012","journal-title":"Arch Intern Med"},{"key":"R12-20260619","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1016\/j.jaci.2022.08.028","article-title":"Drug allergy: A 2022 practice parameter update","volume":"150","author":"Khan","year":"2022","journal-title":"J Allergy Clin Immunol"},{"key":"R14-20260619","doi-asserted-by":"crossref","first-page":"e0230632","DOI":"10.1371\/journal.pone.0230632","article-title":"Angioedemas associated with renin-angiotensin system blocking drugs: Comparative analysis of spontaneous adverse drug reaction reports","volume":"15","author":"Dubrall","year":"2020","journal-title":"PLoS One"},{"key":"R16-20260619","first-page":"246","article-title":"Cutaneous adverse reactions to calcium channel blockers","volume":"32","author":"Tuchinda","year":"2014","journal-title":"Asian Pac J Allergy Immunol"},{"key":"R17-20260619","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s40264-017-0599-x","article-title":"Use of antihypertensive drugs and risk of malignant melanoma: A meta-analysis of observational studies","volume":"41","author":"Tang","year":"2018","journal-title":"Drug Saf"},{"key":"R18-20260619","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1093\/ije\/dyac223","article-title":"Use of antihypertensive drugs and risk of cutaneous melanoma: A nationwide nested case-control study","volume":"52","author":"Ghiasvand","year":"2023","journal-title":"Int J Epidemiol"},{"key":"R19-20260619","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1111\/all.15996","article-title":"EAACI\/ENDA position paper on drug provocation testing","volume":"79","author":"Barbaud","year":"2024","journal-title":"Allergy"},{"key":"R20-20260619","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.3390\/jcm14041097","article-title":"Amlodipine-associated angioedema: An integrated pharmacovigilance assessment using disproportionality and interaction analysis and case reviews","volume":"14","author":"Sridharan","year":"2025","journal-title":"J Clin Med"},{"key":"R21-20260619","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1111\/all.15214","article-title":"The international WAO\/EAACI guideline for the management of hereditary angioedema-The 2021 revision and update","volume":"77","author":"Maurer","year":"2022","journal-title":"Allergy"},{"key":"R22-20260619","first-page":"e63655","article-title":"Hydrochlorothiazide-induced exfoliative rash and sepsis","volume":"16","author":"Sheth","year":"2024","journal-title":"Cureus"},{"key":"R23-20260619","doi-asserted-by":"crossref","first-page":"e15174","DOI":"10.1111\/exd.15174","article-title":"Psoriasiform drug eruption: A case series with a review of the literature","volume":"33","author":"Mori","year":"2024","journal-title":"Exp Dermatol"},{"key":"R24-20260619","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1590\/abd1806-4841.20153390","article-title":"Mucosal-dominant pemphigus vulgaris in a captopril-taking woman with angioedema","volume":"90","author":"Gornowicz-Porowska","year":"2015","journal-title":"An Bras Dermatol"},{"key":"R25-20260619","first-page":"76","article-title":"Telangiectasias fotodistribuidas asociadas a amlodipino","volume":"108","author":"Rojas Mora","year":"2016","journal-title":"Actas Dermo-Sifiliogr\u00e1ficas"},{"key":"R26-20260619","first-page":"e42202","article-title":"Angioedema: A possible complication of amlodipine use","volume":"15","author":"Russo","year":"2023","journal-title":"Cureus"},{"key":"R27-20260619","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12245-024-00772-5","article-title":"Disposition of emergency department patients presenting with angiotensin-converting enzyme inhibitor-induced angioedema","volume":"18","author":"Briggs","year":"2025","journal-title":"Int J Emerg Med"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1859_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:36:05Z","timestamp":1787067365000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1859_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_1859_25","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-10-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-06","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}