Abstract
Glioblastoma is the most common form of primary brain cancer. Its treatment involves surgery, radiotherapy, and chemotherapy with temozolomide (tmz), which is an oral alkylating agent. To the best of our knowledge, few dermatologic side effects of tmz have been described. We report two cases of cutaneous drug eruption caused by tmz during and after radiochemotherapy treatment. In the first case, all tests were negative, but the clinical history and the time of onset supported an allergy to tmz. In the second case, an allergy to tmz was proved by a positive lymphocyte activation test. In this context, our study is one of a very few trying to determine dermatologic side effects by applicable tests used in routine practice.
Highlights
Glioblastoma is the most common form of primary brain cancer and one of the most aggressive cancers
The lymphocyte activation test was negative for patient 1 and positive for patient 2
The few dermatologic side effects that have been reported include urticarial hypersensitivity reaction, alopecia, desquamative skin rash, Stevens–Johnson syndrome, and toxic epidermal necrolysis overlap[2,4,6,7]. These effects were reported only in patients receiving radiotherapy combined with tmz
Summary
Glioblastoma is the most common form of primary brain cancer and one of the most aggressive cancers. The current standard of treatment involves maximal surgical resection followed by external-beam radiotherapy (60 Gy) and adjuvant temozolomide (tmz), which is administered concomitantly with (75 mg/m2 daily) and after radiotherapy (150–200 mg/m2) for 5 days every 4 weeks[1]. Few reports have described dermatologic side effects such as urticaria[2]. We report two cases of cutaneous drug eruption with the use of tmz, one occurring during radiochemotherapy, and the other concomitant with and after radiochemotherapy. A delayed-type hypersensitivity to tmz was confirmed using the lymphocyte activation test
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