CHRONIC INFLAMMATORY LESIONS OF THE GROIN IN A PATIENT WITH SCHIZOPHRENIA DURING LONG-TERM POLYPHARMACOTHERAPY: A POTENTIAL ADVERSE EFFECT OF ANTIPSYCHOTIC DRUGS

Kaja Nieradka; Krystyna Klahs; Maciej Muraszko-Kuźma; Patryk Twardy; Weronika Wagner; Jakub Białożyt; Anna Dębniak; Maciej Gutarowicz; Patryk  Modelewski; Michał Armatys

doi:10.31435/ijitss.3(51).2026.5843

Authors

Kaja Nieradka Clinical Provincial Hospital of Saint Jadwiga the Queen in Rzeszów, Poland https://orcid.org/0009-0009-4373-3726
Krystyna Klahs Independent Public Specialist Health Care Facility in Lębork, Poland https://orcid.org/0009-0001-7747-6854
Maciej Muraszko-Kuźma District Hospital in Limanowa of the Name of Divine Mercy, Poland https://orcid.org/0009-0003-4812-1493
Patryk Twardy Clinical Provincial Hospital of Saint Jadwiga the Queen in Rzeszów, Poland https://orcid.org/0009-0009-5510-3545
Weronika Wagner Clinical Provincial Hospital of Saint Jadwiga the Queen in Rzeszów, Poland https://orcid.org/0009-0001-0269-0418
Jakub Białożyt University Clinical Hospital No. 2 PUM in Szczecin, Poland https://orcid.org/0009-0000-2721-6694
Anna Dębniak University Clinical Hospital No. 2 PUM in Szczecin, Poland https://orcid.org/0009-0009-8511-3912
Maciej Gutarowicz Independent Public Provincial Hospital in Szczecin, Poland https://orcid.org/0009-0003-5139-3756
Patryk Modelewski University Clinical Hospital No. 2 PUM in Szczecin, Poland https://orcid.org/0009-0009-0682-4901
Michał Armatys UNO-MED Medical Center, Tarnów, Poland https://orcid.org/0009-0003-9647-8091

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.5843

Keywords:

Schizophrenia, Antipsychotic Drugs, Skin Lesions, Polypharmacotherapy, Drug-Induced Hyperhidrosis

Abstract

Objective: This paper presents a case report of a patient with recurrent skin lesions of probable drug-induced etiology. The study highlights the importance of considering adverse drug reactions.

Methods: A detailed clinical interview, medical documentation, and the patient’s pharmacological treatment were analyzed, with particular emphasis on the potential adverse effects of the medications used. The analysis included an assessment of the temporal relationship between the administered drugs and the occurrence of skin lesions, as well as the exclusion of other possible causes, including infectious etiologies. Particular attention was paid to the possibility of a drug-induced nature of the observed lesions.

Key Findings: A patient with long-standing schizophrenia receiving extensive polypharmacotherapy developed chronic inflammatory lesions in the groin area. Comprehensive diagnostic evaluation excluded infectious causes, indicating a probable drug-induced etiology of the lesions. This case highlights the importance of considering adverse drug reactions and polypharmacotherapy in the diagnostic process of chronic skin lesions.

Conclusions: By presenting this case, we aim to emphasize that chronic skin lesions in patients undergoing long-term polypharmacotherapy may most likely be drug-induced, particularly after infectious causes have been excluded. In clinical practice, careful attention should be paid to the medications the patient is taking, as well as to potential drug interactions and adverse effects. With appropriate medical supervision, however, the condition may remain stable and well controlled.

References

Hatziagelaki, E., Tsiavou, A., Gerasimou, C., Vavougios, G. D., Spathis, A., Laskos, E., Papageorgiou, C., Douzenis, A., Christodoulou, N., Stefanis, N., Spandidos, D. A., Nikolakakis, N., Tsamakis, K., & Rizos, E. (2019). Effects of olanzapine on cytokine profile and brain-derived neurotrophic factor in drug-naive subjects with first-episode psychosis. Experimental and Therapeutic Medicine, 17(4), 3071–3076. https://doi.org/10.3892/etm.2019.7285

Lin, J. (2018). Antipsychotics and rashes. Mental Illness, 10(2), Article 7808. https://doi.org/10.4081/mi.2018.7808

Telles-Correia, D., Barbosa, A., Cortez-Pinto, H., Campos, C., Rocha, N. B. F., & Machado, S. (2017). Psychotropic drugs and liver disease: A critical review of pharmacokinetics and liver toxicity. World Journal of Gastrointestinal Pharmacology and Therapeutics, 8(1), 26–38. https://doi.org/10.4292/wjgpt.v8.i1.26

World Medical Association. (2024). WMA Declaration of Helsinki: Ethical principles for medical research involving human participants.

Beyer, C., Cappetta, K., Johnson, J. A., & Bloch, M. H. (2017). Meta-analysis: Risk of hyperhidrosis with second-generation antidepressants. Depression and Anxiety, 34(12), 1134–1146. https://doi.org/10.1002/da.22680

Štuhec, M. (2015). Excessive sweating induced by interaction between agomelatine and duloxetine hydrochloride: Case report and review of the literature. Wiener Klinische Wochenschrift. https://doi.org/10.1007/s00508-014-0688-0

Kisielnicka, A., Szczerkowska-Dobosz, A., Purzycka-Bohdan, D., & Nowicki, R. J. (2022). Hyperhidrosis: Disease aetiology, classification and management in the light of modern treatment modalities. Postępy Dermatologii i Alergologii, 39(2), 251–257. https://doi.org/10.5114/ada.2022.115887

Brackenrich, J., & Medeus, C. F. (2022). Hyperhidrosis. In StatPearls. StatPearls Publishing.

Correll, C. U., et al. (2024). Antipsychotic polypharmacy: A comprehensive evaluation of relevant correlates of a long-standing clinical practice. The Lancet Psychiatry, 11(7), 545–557. https://doi.org/10.1016/S2215-0366(24)00314-6.

Hwang, S. M., et al. (2023). Cutaneous adverse drug reactions associated with psychotropic medications. Dermatopathology, 3(1), Article 2. https://doi.org/10.3390/dermatopathology3010002.

Guglielmo, R., et al. (2022). Immune system dysregulation in schizophrenia and the potential role of antipsychotic treatment. International Journal of Molecular Sciences, 23(19), Article 11932. https://doi.org/10.3390/ijms231911932.