Embolia cutis medicamentosa following subcutaneous injection of glatiramer acetate.
Embolia cutis medicamentosa (ECM) is a rare side effect observed primarily after intramuscular injections. It is associated with localized, sometimes extensive necrosis of the skin. Reflex vasospasm induced by the injection trauma may be etiologically involved. It is a potentially serious reaction which is little influenced by which drug is injected. A patient developed typical ECM after subcutaneous selfinjection of glatiramer acetate for multiple sclerosis. This case is remarkable since 1) ECM developed after subcutaneous and not after intramuscular injection, 2) the injection was given by the patient himself, and 3) glatiramer acetate can induce skin necrosis as a side effect. ECM can be easily differentiated from the latter by its typical clinical features.
Department of Dermatology, Allergy and Venereology, University of Schleswig-Holstein, Campus Kiel, Germany.
Viola
V
Harde
Thomas
T
Schwarz
D000005:Abdomen; D004334:Drug Administration Schedule; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology*; D000068717:Glatiramer Acetate; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000633:toxicity*; D007279:Injections, Subcutaneous; D015603:Keratinocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy*; D009336:Necrosis; D010455:Peptides / Q000008:administration & dosage / Q000633:toxicity*; D012867:Skin / Q000098:blood supply / Q000473:pathology; D013927:Thrombosis / Q000139:chemically induced* / Q000175:diagnosis
D007166:Immunosuppressive Agents; D010455:Peptides; D000068717:Glatiramer Acetate