Exacerbation of Psoriasis by the Hypolipidemic Agent, Gemfibrozil

To the Editor.—  Elicitation or exacerbation of psoriasis has occurred following administration of the psychopharmacologic agents,¹ β-blockers,² nonsteroidal anti-inflammatory agents,³ antimalarials,⁴ isotretinoin,⁵ and chlorthalidone.⁶ Abel and coworkers⁷ have extensively analyzed and discussed the entire subject of drug-induced psoriasis in an excellent recent review.We report herein a case of psoriasis exacerbated by gemfibrozil, a hypolipidemic fibric acid derivative, in the same category as clofibrate. Gemfibrozil decreases production of very-low-density lipoprotein (VLDL) triglycerides and enhances its clearance, but does not decrease plasma cholesterol.⁸ It does, however, increase high-density lipoprotein (HDL) cholesterol levels.^8,9 Its mechanism of action, as discussed below, is unclear.⁸ There are no previous reports of psoriasis exacerbated by gemfibrozil (Lopid, Parke-Davis). Moreover, a recent computer search by the American Academy of Dermatology Adverse Drug Reporting Center (Evanston, Ill) failed to reveal any prior reports of this phenomenon.

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