Thalidomide-induced morbilliform rash: diagnosis and continuation of therapy, premedicated with methylprednisolone.
In the past few years, thalidomide is experiencing a revival in many different fields as a last therapeutic option, because of the potential severe adverse drug reactions (ADR) induced by this drug (teratogenicity, peripheral neuropathy and sedation). Taking into consideration the increased use, we should focus on the prevalence of these and other ADR as well on their management. We describe a patient with multiple myeloma who presented with a morbilliform rash induced by thalidomide. Reintroduction of the drug confirmed the diagnosis. Nevertheless we continued the thalidomide treatment, although combined with methylprednisolone 64 mg. There was no recurrence of the cutaneous drug reaction (CDR). To the best of our knowledge, this is the first case showing that systemic steroids can help to 'treat through' a thalidomide CDR.
Nijsten
T
T
Department of Dermatology, University Hospital Antwerp, Belgium.
Meuleman
L
L
Schroyens
W
W
Lambert
J
J
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003875:Drug Eruptions / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D009101:Multiple Myeloma / Q000188:drug therapy; D013792:Thalidomide / Q000009:adverse effects* / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D013792:Thalidomide; D008775:Methylprednisolone