Brentuximab vedotin
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Brentuximab vedotin DRESS syndrome: case report
A 50-year-old woman developed drug rash with eosinophilia and systemic symptoms (DRESS) syndrome during treatment with brentuximab for T-cell lymphoma. The woman, who had a 5-year history of pruritic, erythematous skin eruptions that transformed into hypopigmented plaques. She received unspecified steroid, which helped transiently along with topical corticosteroids for possible eczema. Over the period of 2 years, she developed tumour on the left wrist along with additional tumors on the face and bilateral upper and lower extremities. In May 2013, she was diagnosed with cutaneous T-cell lymphoma (CTCL). She received total skin electron irradiation, which was completed in January 2014 with a near-complete response. Subsequently, she received bexarotene, interferon and photochemotherapy; however, this treatment was discontinued due to poor tolerance. Therefore, she received interferon and vorinostat. On further evaluation, she was diagnosed with Pseudomonas and Staphylococcus aureus infection. Further examination showed lymphadenopathy, which showed disease progression. She was started on doxorubicin. Then she was started on bexarotene with mechlorethamine, clobetasol and triamcinolone. She again developed sloughing of the hands, arms and breasts, which was painful. Therefore, she was started on doxorubicin-liposomal again and received 5 additional cycles. Lesions were worsened further and her treatment was replaced with gemcitabine. Thereafter, she developed lesions on the back, buttocks and thighs. Further examination showed large cell transformation of the skin, which was CD30 positive. She received local radiation therapy in combination with topical methylrosanilinium chloride [gentian violet] to the open areas. On 29 March 2018, she was started on conventional therapy and brentuximab vedotin [route and dosage not stated], which was an antibody to CD-30. However, following cycle-4, she developed DRESS syndrome associated with brentuximab vedotin [duration of treatment to reaction onset not stated]. The woman’s treatment with brentuximab vedotin was discontinued. On 15 November 2018, she was started on mogamulizumab along with methylrosanilinium chloride. Eventually, the combination of local treatment with radiation, methylrosanilinium chloride with mogamulizumab resulted in remission of end-stage CTLC [outcome of ADR not stated]. Westergaard SA, et al. Induction of remission in a patient with end-stage cutaneous T-cell lymphoma by concurrent use of radiation therapy, gentian violet, and mogamulizumab. JAAD Case Reports 6: 761-765, No. 8, Aug 2020. Available from: URL: http://doi.org/10.1016/j.jdcr.2020.05.035
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Reactions 5 Sep 2020 No. 1820
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