PDF herunterladen
Z Geburtshilfe Neonatol
DOI: 10.1055/a-2615-1248
Case Report

Annular Migratory Rash In a Newborn Related to Prostaglandin E1 Infusion: A Case Report

Buse Önen Ocak 
1   Department of Pediatrics, Division of Neonatology, Ministry of Health Ankara Bilkent City Hospital, Çankaya, Turkey (Ringgold ID: RIN536164)
,
Refika Sirma Dokuzboy
1   Department of Pediatrics, Division of Neonatology, Ministry of Health Ankara Bilkent City Hospital, Çankaya, Turkey (Ringgold ID: RIN536164)
,
Hayriye Gözde Kanmaz Kutman
1   Department of Pediatrics, Division of Neonatology, Ministry of Health Ankara Bilkent City Hospital, Çankaya, Turkey (Ringgold ID: RIN536164)
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Prostaglandin E1 (PGE1, alprostadil) is essential in managing ductus-dependent congenital heart defects (CHD) in neonates. Although its common adverse effects are well documented, dermatologic manifestations remain rare and underrecognized. We report a term male neonate with a prenatal diagnosis of complex critical CHD who required PGE1 infusion and subsequently developed an annular migratory rash on the third postnatal day. The rash resolved within minutes of PGE1 dose reduction but recurred upon dose escalation, strongly suggesting a causal link. Following surgical palliation and discontinuation of PGE1, the skin findings resolved completely and did not recur. This case underscores a rare but distinctive cutaneous reaction to PGE1 therapy and highlights the importance of early recognition to avoid unnecessary diagnostic testing and interruption of life-saving treatment.

Keywords

Congenital Heart Disease - Prostaglandin E1 - Newborn - Migratory Rash - Side effect


Publikationsverlauf

Eingereicht: 27. September 2024

Angenommen nach Revision: 07. Mai 2025

Artikel online veröffentlicht:
06. Juni 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Hew MR, Gerriets V. Prostaglandin E1. In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing LLC; 2025
    Suche in Google Scholar
  • 2 Barst RJ, Gersony WM. The pharmacological treatment of patent ductus arteriosus. Drugs 1989; 38: 249-266
    CrossrefPubMedSuche in Google Scholar
  • 3 Chamberlin M, Lozynski J. To go against nature: manipulating the neonatal ductus arteriosus with prostaglandin. Newborn Infant Nurs Rev 2006; 6: 158-162
    CrossrefPubMedSuche in Google Scholar
  • 4 Lewis AB, Freed MD, Heymann MA. et al. Side effects of therapy with prostaglandin E1 in infants with critical congenital heart disease. Circulation 1981; 64: 893-898
    CrossrefPubMedSuche in Google Scholar
  • 5 Tálosi G, Katona M, Rácz K. et al. Prostaglandin E[1] treatment in patent ductus arteriosus dependent congenital heart defects. J Perinat Med 2004; 32: 368-374
    CrossrefPubMedSuche in Google Scholar
  • 6 Tálosi G, Katona M, Túri S. Side-effects of long-term prostaglandin E1 treatment in neonates. Pediatr Int 2007; 49: 335-340
    CrossrefPubMedSuche in Google Scholar
  • 7 Vari D, Xiao W, Behere S. et al. Low-dose prostaglandin E1 is safe and effective for critical congenital heart disease: is it time to revisit the dosing guidelines?. Cardiol Young 2021; 31: 63-70
    CrossrefPubMedSuche in Google Scholar
  • 8 Aykanat A, Yavus T, Özalikaya E. et al. Long-term prostaglandin E1 Infusion for newborns with critical congenital heart disease. Pediatr Cardiol 2016; 37: 131-134
    CrossrefPubMedSuche in Google Scholar
  • 9 Lacher M, Schneider K, Dalla Possa R. et al. Gastric outlet obstruction after long-term prostaglandin administration mimicking hypertrophic pyloric stenosis. Eur J Pediatr Surg 2007; 17: 362-364
    Thieme ConnectPubMedSuche in Google Scholar
  • 10 Velaphi S, Cilliers A, Beckh-Arnold E. et al. Cortical hyperostosis in an infant on prolonged prostaglandin infusion: case report and literature review. J Perinatol 2004; 24: 263-265
    CrossrefPubMedSuche in Google Scholar
  • 11 Sharata H, Postellon DC, Hashimoto K. Subcutaneous fat necrosis, hypercalcemia, and prostaglandin E. Pediatr Dermatol 1995; 12: 43-47
    CrossrefPubMedSuche in Google Scholar
  • 12 Carter EL, Garzon MC. Neonatal urticaria due to prostaglandin E1. Pediatr Dermatol 2000; 17: 58-61
    CrossrefPubMedSuche in Google Scholar
  • 13 Rao J, Campbell ME, Krol A. The harlequin color change and association with prostaglandin E1. Pediatr Dermatol 2004; 21: 573-576
    CrossrefPubMedSuche in Google Scholar
  • 14 Tsuboi K, Tsuboi N, Nosaka N. et al. Neonatal harlequin color change associated with prostaglandin E(1) administration. Pediatr Int 2021; 63: 610-611
    CrossrefPubMedSuche in Google Scholar
  • 15 Panigrahi NK, Venkatesh HA. Prostaglandin E1-induced urticaria with harlequin change in a neonate with transposition of great vessels: A case report. Karnataka Paediatr J 2024; 39: 88-90
    CrossrefPubMedSuche in Google Scholar
  • 16 Young GJ, Harter N, Luu M. An unusual migratory polycyclic eruption after administration of prostaglandin E in a neonate. JAAD Case Rep 2016; 2: 377-379
    CrossrefPubMedSuche in Google Scholar
  • 17 Wheless L, Murray LE, Siddiqui F. et al. Re: An unusual migratory polycyclic eruption after administration of prostaglandin E in a neonate. JAAD Case Rep 2017; 3: 342-343
    CrossrefPubMedSuche in Google Scholar
  • 18 Shah A, El-Feghaly J, Bender AM. Prostaglandin E-induced polycyclic cutaneous eruption with geometric features. Pediatr Dermatol 2024; 41: 934-935
    CrossrefPubMedSuche in Google Scholar
  • 19 Sondergaard J, Greaves MW. Prostaglandin E1: effect on human cutaneous vasculature and skin histamine. Br J Dermatol 1971; 84: 424-428
    CrossrefPubMedSuche in Google Scholar
  • 20 Agnihotri G, Tsoukas MM. Annular skin lesions in infancy. Clin Dermatol 2023; 41: 405-412
    CrossrefPubMedSuche in Google Scholar
  • 21 Ly S, Guram M, Zoumberos N. et al. Annular erythema of infancy: A rare and challenging diagnosis. Pediatr Dermatol 2023; 40: 681-687
    CrossrefPubMedSuche in Google Scholar