Lenalidomide
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Drug-induced photosensitivity rash: case report A 60‑year‑old man developed photosensitive rash during treatment with lenalidomide for non-Hodgkin’s lymphoma. The case was reported to Pharmacovigilance Programme of India (PvPI) (Report no. 2019/24027). The man, who had non-Hodgkin’s lymphoma for 3 years, was treated with CHOP regimen comprising of cyclophosphamide, doxorubicin [hydroxydaunorubicin], vincristine [oncovin] and prednisolone, followed by ifosfamide and etoposide. After that, he started receiving lenalidomide 10 mg/day tablet [route not stated]. After 20 days from the initiation of lenalidomide, he complained of a reddish raised rash over face, extremities and trunk associated with moderate to severe itching. He had no history of intake of any other photosensitive drug. Cutaneous examination showed several erythematous scaly plaques over extensor aspects of both forearms, face, wrists, chest, neck and upper part of the back. Few erythematous papules were present over back, abdomen, legs and thigh. Skin‑colored nodules and plaques were present over posterior aspect of right leg. General examination only showed inguinal lymphadenopathy. Peripheral smear showed atypical lymphocytes. Histopathological examination of erythematous scaly plaque from the extensor aspect of right forearm showed mild acanthosis, spongiosis with formation of spongiotic vesicle in epidermis and perivascular lymphocytic infiltrate in upper dermis. These findings were indicative of photosensitive dermatitis. The man’s treatment with lenalidomide was stopped and was treated with prednisolone, unspecified antihistamines and broad‑spectrum sunscreen. After 2 weeks of treatment, his symptoms resolved significantly in the form of diminution of erythema and scaling. He was lost to follow‑up after 2 weeks. Based upon history, clinical features and histopathology, a diagnosis of lenalidomide-induced photosensitive rash was made. Based on the World Health Organization (WHO) Uppsala Monitoring Center (UMC) scale, photosensitivity due to lenalidomide was considered as probable adverse drug reaction. Based on Schumock and Thornton preventability scale, he had a definitive preventable type of adverse drug reaction. Soni R, et al. A rare case report of photosensitivity in non-hodgkin’s lymphoma treated with lenalidomide. Indian Journal of Dermatology 65: 333-335, No. 4, Jul-Aug 2020. 803497275 Available from: URL: http://doi.org/10.4103/ijd.IJD_64_19
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Reactions 22 Aug 2020 No. 1818
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