Erythema Multiforme-Like Skin Reaction Induced by Lenalidomide

Christin Kronschläger

doi:10.4172/2155-6121.1000145

Christin Kronschläger

Open Access

https://doi.org/10.4172/2155-6121.1000145

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Abstract

The thalidomide analogues, with lenalidomide as the leading compound, have effectivity in the treatment of multiple myeloma and myelodysplastic syndromes. With this class of immunomodulatory drugs immune mediated adverse events are common. Skin eruptions are frequent side effects, ranging from mild exanthemas to the rare but severe Stevens-Johnson syndrome. We report herein a case of an erythema multiforme-like skin eruption in a female patient with multiple myeloma. The reaction occurred during the second cycle of the treatment with lenalidomide and dexamethasone, required cessation of therapy and the application of systemic and topical corticosteroids.

Highlights

Lenalidomide (Revlimid®; Celgene Corporation, Summit, NJ, USA) in combination with dexamethasone is used for second line treatment of patients with multiple myeloma [1]
In some countries (Argentinia, Canada, USA) lenalidomide is approved for the treatment of myelodysplastic syndrome and it is actively evaluated for the use in other hematologic tumor entities as well as in solid tumors [2,3,4,5,6]
Most eruptions occur in the first month of therapy and have been described as morbilliform, urticarial, eczematous or acneiform [9]

Summary

Introduction

Lenalidomide (Revlimid®; Celgene Corporation, Summit, NJ, USA) in combination with dexamethasone is used for second line treatment of patients with multiple myeloma [1]. Because of persisting myeloma M protein VMP regimen was stopped after the 5th treatment cycle and oral therapy with lenalidomide 25 mg for 21 days and dexamethasone 20 mg on days 1, 8 and 15 was initiated (Rd regimen with low dose dexamethasone). This treatment had to be paused for three days due to impaired general condition, sweating and dizziness. On day 14 of the 2nd cycle (day 45 from treatment initiation) the patient developed erythematous maculae affecting the arms and legs.

Study Design Reference

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