title: Disease modifying agent related skin reactions in multiple sclerosis: prevention, assessment, and management.
abstract: BACKGROUND
  The objective for this article is to highlight some of the adverse skin manifestations associated with injectable disease modifying therapy for multiple sclerosis (MS). Early identification and intervention can often lead to minimal consequences and prolonged patient tolerance and compliance with these agents. At the University of Texas Southwestern Medical Center at Dallas and Texas Neurology in Dallas we actively follow approximately 5000 MS patients. The majority of our patients with relapsing-remitting MS (RRMS) or secondary progressive MS (SPMS) are treated with one of the currently available disease modifying agents (DMAs). Our experience with these patients, and the challenges they face in continuing long-term treatment, constitutes the basis of our proposed treatment strategies.
  
  
  CONCLUSIONS
  Skin reactions in response to injectable DMA therapy in MS are generally mild. However, some reactions can evolve into potentially serious lesions culminating in infection, necrosis, and in some circumstances requiring surgical repair.
authors.affiliation: Department of Neurology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75235, USA. elliot.frohman@utsouthwestern.edu
authors.forename: E M
authors.initials: EM
authors.lastname: Frohman
authors.forename: K
authors.initials: K
authors.lastname: Brannon
authors.forename: Sherry
authors.initials: S
authors.lastname: Alexander
authors.forename: D
authors.initials: D
authors.lastname: Sims
authors.forename: J T
authors.initials: JT
authors.lastname: Phillips
authors.forename: S
authors.initials: S
authors.lastname: O'Leary
authors.forename: K
authors.initials: K
authors.lastname: Hawker
authors.forename: M K
authors.initials: MK
authors.lastname: Racke
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D000328:Adult; D004890:Erythema / Q000139:chemically induced / Q000473:pathology; D000068717:Glatiramer Acetate; D006801:Humans; D000068556:Interferon beta-1a; D016899:Interferon-beta / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000188:drug therapy* / Q000473:pathology; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy*; D009336:Necrosis; D010455:Peptides / Q000009:adverse effects*; D012867:Skin / Q000187:drug effects / Q000473:pathology; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000276:Adjuvants, Immunologic; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta; D000068556:Interferon beta-1a