Haq M, Reyal Y, Tiffin N, Szakacs S, Ferguson L
Faculty of Medicine St George's, University of London London UK.
Department of Haematology St George's Healthcare NHS Trust London UK.
Skin Health Dis. 2021 Jun 30;1(3):e57. doi: 10.1002/ski2.57. eCollection 2021 Sep.
We present a case of a 54-year-old male with multiple myeloma (MM) who presented with widespread pruritic erythematous lesions following ixazomib treatment. This occurred after his third cycle of treatment with ixazomib, thalidomide and dexamethasone and was controlled by potent steroids and temporary cessation of ixazomib. The strong correlation between the timeline of the rash, ixazomib treatment and subsequent cessation led to a diagnosis of a drug-induced rash. Skin biopsy histology, immunochemistry and the absence of monoclonal T-cell receptor gene rearrangement further confirmed the diagnosis of a T-cell pseudolymphoma secondary to ixazomib. Ixazomib is an oral proteasome inhibitor used in the treatment of MM. Other proteasome inhibitors have been reported to trigger cutaneous adverse effects. However, to our knowledge, this is the first report of pseudolymphoma following proteasome inhibitor use. Dermatologists should be aware of this potential effect and the possible management pathways such as cessation and dose reduction.
我们报告一例54岁男性多发性骨髓瘤（MM）患者，其在接受伊沙佐米治疗后出现广泛的瘙痒性红斑病变。这发生在他接受伊沙佐米、沙利度胺和地塞米松联合治疗的第三个周期后，通过强效类固醇药物控制，并暂时停用伊沙佐米。皮疹出现的时间线、伊沙佐米治疗及随后的停药之间存在密切关联，从而诊断为药物性皮疹。皮肤活检组织学、免疫化学检查以及单克隆T细胞受体基因重排的缺失进一步证实了继发于伊沙佐米的T细胞假性淋巴瘤的诊断。伊沙佐米是一种用于治疗MM的口服蛋白酶体抑制剂。据报道，其他蛋白酶体抑制剂可引发皮肤不良反应。然而，据我们所知，这是蛋白酶体抑制剂使用后发生假性淋巴瘤的首例报告。皮肤科医生应意识到这种潜在影响以及可能的处理方法，如停药和减量。
