Bortezomib-Induced Reticular Eruption in Patient with Multiple Myeloma.
Joseph HanShayan OwjiAneesh AgarwalSamir KamatYen LuuAdnan MubasherGeorge NiedtChloe RayHearn Jay ChoNicholas GulatiAngela LambPublished in: Dermatopathology (Basel, Switzerland) (2023)
Bortezomib is the first proteasome inhibitor to treat a variety of malignancies and is currently part of the standard of care regimen for the initial treatment of patients with newly diagnosed multiple myeloma. While bortezomib is generally well tolerated, it has been associated with various side effects, which have limited its use in some patients. Here, we describe a unique case with histological confirmation of a reticular eruption that appeared at the site of a subcutaneous administration of bortezomib in a 62-year-old male who was newly diagnosed with IgG kappa multiple myeloma. A skin biopsy was performed, which revealed superficial perivascular dermatitis predominantly composed of lymphocytes with rare eosinophils. The patient was successfully treated with betamethasone dipropionate 0.05% cream. When consulted, dermatologists should advise the oncology team of multiple myeloma patients treated with bortezomib to maintain a high threshold before discontinuing the drug when a patient experiences an atypical, reticular rash following subcutaneous administration. Additionally, potent topical corticosteroids, such as betamethasone dipropionate 0.05% cream, should be considered in managing the cutaneous reticular eruptions related to bortezomib administration, in order to maintain an optimal treatment regimen for patients with multiple myeloma.
Keyphrases
- multiple myeloma
- newly diagnosed
- palliative care
- case report
- healthcare
- end stage renal disease
- emergency department
- ejection fraction
- chronic kidney disease
- quality improvement
- drug induced
- nuclear factor
- immune response
- toll like receptor
- diabetic rats
- wound healing
- high glucose
- patient reported outcomes
- soft tissue
- oxidative stress
- replacement therapy
- pain management
- adverse drug