Lenalidomide

Abstract

Lenalidomide Perforating folliculitis: case reportA 59-year-old man developed perforating folliculitis during treatment with lenalidomide.The man diagnosed with myelofibrosis 3 years prior, developed chest pain due to increasing anaemia. He received prednisolone for several weeks and then, he was started on thalidomide; however, 6 months later due to polyneuropathy, thalidomide was switched to oral lenalidomide 10 mg once a day. Lenalidomide was well tolerated and his chest pain disappeared. Sixteen months after starting lenalidomide, he had painful and itchy pustules, papules and nodules partly erythematous and scaling, but he presented 2 months later. Four weeks earlier he was started on tetracycline without any improvement. His histopathological examination was consistent with perforating folliculitis.The man was treated with intralesional triamcinolone for painful nodules. In addition, he received doxycycline and triamcinolone in sodium fusidate ointment without improvement. He developed diarrhoea and his doxycycline was withdrawn and topical tretinoin was added to the treatment. His lenalidomide was discontinued and within 3 weeks almost all inflammatory elements and pustules had disappeared with residual hyper-pigmented scars and a single red nodule.Author comment: "We concluded that perforating folliculitis was a late-onset cutaneous adverse drug reaction due to lenalidomide."Kuiper EM, et al. Late onset perforating folliculitis induced by lenalidomide: A case report.