Bortezomib-Induced Skin Eruption

Abstract

Bortezomib (Velcade®) is a proteasome inhibitor recently developed and mainly used for the treatment of multiple myeloma. Bortezomib represents a novel class of drugs functioning as proteasome inhibitors. Skin complications of bortezomib treatment are very frequent but poorly characterized. We describe the case of a patient who developed erythematous and edematous plaques after treatment with bortezomib. This case illustrates one of the potential reactions associated with bortezomib administration and underlines the need to recognize and report cutaneous side effects of this new drug.

Skin lesions caused by bortezomib targeted therapy of multiple myeloma

“…Bortezomib is the firstin-class proteasome inhibitor, which has been used in the treatment of multiple myeloma, mantle cell lymphoma and non-Hodgkin lymphoma. Despite the fact that cutaneous adverse reactions caused by bortezomib are quite frequent, they are poorly described in the medical literature [1,2]. To our knowledge, this is the first report in Poland on an adverse cutaneous reaction caused by bortezomib.…”

“…observed in 8-24% of patients [1,2]. They are characterized by diversity of the clinical and histopathological presentation.…”

“…The clinical spectrum of skin lesions described so far includes: different forms of rash (maculopapular, papulonodular, nodular, vasculitic, acneiform, purpuric, "folliculitis-like"), small vessel vasculitis, Sweet syndrome, Sweet-like syndrome, and lupus tumidus. Histopathological features of skin lesions generally show various vasculitis reactions [2,4,5]. The response to topical or systemic glucocorticosteroid treatment is usually quick and rewarding.…”

Bortezomib-Induced Lupus Erythematosus Tumidus

“…"Rash," a side effect of bortezomib therapy, has been reported in up to 8%-40% of patients in clinical trials [5][6][7]. Several reports describe cutaneous side effects in detail and the diagnosis ranges from systemic hypersensitivity reaction [7], leukocytoclastic vasculitis [8 -11], and drug eruption [6,12,13] (Table 1) to Sweet's syndrome [14,15].…”

“…Several reports describe cutaneous side effects in detail and the diagnosis ranges from systemic hypersensitivity reaction [7], leukocytoclastic vasculitis [8 -11], and drug eruption [6,12,13] (Table 1) to Sweet's syndrome [14,15]. These cases illustrate the importance of further investigations to define the rash and to find a diagnosis in order to determine further procedures and appropriate treatment.…”