Leflunomide
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First report of disseminated cutaneous and visceral Kaposi’s sarcoma: case report A 57-year-old woman developed disseminated cutaneous and visceral Kaposi’s sarcoma (KS) during treatment with leflunomide for severe erosive rheumatoid arthritis (RA). The woman had a 30-year history of RA and had been treated with various agents prior to initiation of leflunomide [dosage and route not stated] in May 2005 alongside existing triamcinolone therapy. In September 2005, she developed skin lesions which slowly progressed over the next 4 years. She presented in April 2009 with tenderness and raised purpuric nodules in both her lower and upper extremities. Physical examination revealed multiple erythematous and haemorrhagic blisters. Laboratory tests were unremarkable although human herpes virus type 8 IgG antibody was detected. CT scans of her chest, abdomen and pelvis showed a small amount of left pleural effusion and subsegmental atelectasis of both basal lungs. Endoscopy of her stomach and duodenum revealed a strawberry coloured mass lesion which displayed features of lymphangioma. Histological examination of the skin lesions showed fusiform or spindle-shaped cells and RBC extravasation. She was diagnosed with KS. Leflunomide was discontinued and chemotherapy with paclitaxel was initiated. The woman’s skin lesions dramatically regressed following the first course of therapy. A second cycle of chemotherapy was performed and her skin lesions improved further and after 3 months only white-purple coloured pigmentation remained. Author comment: We report "a case of disseminated cutaneous and visceral involved KS in a patient with severe RA who received leflunomide". Lee SY, et al. Disseminated cutaneous and visceral Kaposi sarcoma in a woman with rheumatoid arthritis receiving leflunomide. Rheumatology International 32: 1065-1068, No. 4, Apr 2012. Available from: URL: http://dx.doi.org/10.1007/ 803077092 s00296-009-1354-0 - South Korea
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Editorial comment: A search of AdisBase, Medline, Embase and the WHO ADR database did not reveal any previous case reports of Kaposi’s sarcoma associated with leflunomide.
0114-9954/10/1420-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 22 Sep 2012 No. 1420
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