To the Editor:
Bosentan is an orally administered dual endothelin-1 receptor antagonist approved for use in patients with pulmonary arterial hypertension and for reducing the number of new digital ulcers in patients with systemic sclerosis (SSc). Adverse events associated with bosentan are mainly teratogenicity and hepatotoxicity. We describe a patient with SSc who had previous skin allergy occurrence following the use of various drugs, and who developed a severe hypersensitive reaction after bosentan administration. Bosentan contains a –SO2NH2 moiety and belongs to the sulfonamide nonantibiotic drugs that might have contributed to this adverse event.
A 71-year-old woman weighing 63 kg was diagnosed with SSc 16 years before and was classified as having diffuse cutaneous disease with positive antitopoisomerase I antibodies. Her disease had led to pulmonary fibrosis but without significant restrictive syndrome and also to recurrent digital ulcerations. Her longterm …
Address correspondence to Dr. Allanore; E-mail: yannick.allanore{at}cch.aphp.fr