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Ciccarese G, Zanghì A, Herzum A, Fidanzi C, Parodi M, Drago F. Acute urticaria following ofatumumab injection for multiple sclerosis. Mult Scler 2024:13524585241273084. [PMID: 39183725 DOI: 10.1177/13524585241273084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Affiliation(s)
- Giulia Ciccarese
- Unit of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy Emanuele D'Amico
| | - Aurora Zanghì
- Neurology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Astrid Herzum
- Dermatology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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Wu X, Lv Z, Li W, Meng Z, Wan SP. Epidermolysis bullosa acquisita as an adverse effect from rituximab therapy: A case report. Medicine (Baltimore) 2020; 99:e23496. [PMID: 33285756 PMCID: PMC7717850 DOI: 10.1097/md.0000000000023496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Rituximab is a monoclonal antibody directed against B cells and is a first-line agent for the treatment of B cell lymphoma and a second-line agent for the treatment of idiopathic thrombocytopenic purpura (ITP). It has also been used for the treatment of several other autoimmune diseases. Epidermolysis bullosa acquisita (EBA) has never been reported as an adverse effect resulted from rituximab therapy. PATIENT CONCERNS A 54-year-old female presented with relapse of the ITP for around eight months. She was treated with rituximab. Intramuscular chlorpheniramine and intravenous methylprednisolone and cimetidine were used as premedication before rituximab infusion. The infusion was initially started at 50 mg/h for 1 h followed by 100 mg/h till the end of infusion. The day after rituximab infusion, the patient noticed pruritic blisters on both arms and chest skin. The next day, the lesions increased in severity and extent. DIAGNOSIS The skin biopsy established the diagnosis of EBA. H&E staining revealed subepidermal blisters infiltrated by inflammatory cells, including eosinophils and lymphocytes. Direct immunofluorescence (DIF) showed linear deposition of IgG and C3 at the dermoepidermal junction. Indirect immunofluorescence with the patient's serum on salt-split skin revealed exclusive dermal binding of circulating IgG antibasement membrane antibodies at a titer of 1:160. INTERVENTIONS She was treated with intravenous methylprednisolone and was continued on oral prednisolone. OUTCOMES The lesions regressed. Six weeks later, she had a recurrence of similar lesions but in milder form. This episode subsided in 4 to 5 days with topical steroid application. LESSONS Physicians should consider this diagnosis when a patient develops bullous skin eruptions while undergoing Rituximab therapy.
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Affiliation(s)
| | | | | | | | - Shaw P. Wan
- The People's Hospital of Huantai County, Zibo, Shandong, China
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Joly E, Rimond O, Salaun V, Comoz F, Morice C, Dompmartin A, Verneuil L. [Localized urticarial rituximab-induced reaction in primary cutaneous marginal zone B-cell lymphoma]. Ann Dermatol Venereol 2019; 147:50-52. [PMID: 31635943 DOI: 10.1016/j.annder.2019.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 04/02/2019] [Accepted: 09/04/2019] [Indexed: 11/26/2022]
Affiliation(s)
- E Joly
- Service de dermatologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France; Université de Caen Normandie, Medical School, 14000 Caen, France.
| | - O Rimond
- Service de dermatologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France
| | - V Salaun
- Service d'hématologie biologique, CHU de Caen, 14033 Caen, France
| | - F Comoz
- Service d'anatomie pathologie, CHU de Caen, 14033 Caen, France
| | - C Morice
- Service de dermatologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France
| | - A Dompmartin
- Service de dermatologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France; Université de Caen Normandie, Medical School, 14000 Caen, France
| | - L Verneuil
- Service de dermatologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France
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T-Cell-Rich Recurrence of Primary Cutaneous Follicle Center Lymphoma After Systemic Rituximab: A Diagnostic Pitfall. Am J Dermatopathol 2019; 42:e36-e40. [PMID: 31592859 DOI: 10.1097/dad.0000000000001544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report on a 74-year-old man with a cutaneous B-cell follicle center lymphoma, which was treated upfront with systemic rituximab and suffered several local relapses. The first of the local recurrences, 10 months after completion of treatment, was characterized by a dense T-cell infiltrate that obscured a minor population of B-cell lymphoma cells, suggesting a second primary cutaneous T-cell lymphoma. This represents a previously not reported diagnostic pitfall and underscores the importance of performing sequential biopsies when dealing with lymphoma recurrences in this setting.
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Lima M. Cutaneous primary B-cell lymphomas: from diagnosis to treatment. An Bras Dermatol 2016; 90:687-706. [PMID: 26560215 PMCID: PMC4631235 DOI: 10.1590/abd1806-4841.20153638] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Accepted: 06/05/2014] [Indexed: 12/19/2022] Open
Abstract
Primary cutaneous B-cell lymphomas are a heterogeneous group of mature B-cells neoplasms with tropism for the skin, whose biology and clinical course differ significantly from the equivalent nodal lymphomas. The most indolent forms comprise the primary cutaneous marginal zone and follicle center B-cell lymphomas that despite the excellent prognosis have cutaneous recurrences very commonly. The most aggressive forms include the primary cutaneous large B-cell lymphomas, consisting in two major groups: the leg type, with poor prognosis, and others, the latter representing a heterogeneous group of lymphomas from which specific entities are supposed to be individualized over time, such as intravascular large B-cell lymphomas. Treatment may include surgical excision, radiotherapy, antibiotics, corticosteroids, interferon, monoclonal antibodies and chemotherapy, depending on the type of lymphoma and on the type and location of the skin lesions. In subtypes with good prognosis is contraindicated overtreatment and in those associated with a worse prognosis the recommended therapy relies on CHOP-like regimens associated with rituximab, assisted or not with local radiotherapy. We review the primary cutaneous B-cell lymphomas, remembering the diagnostic criteria, differential diagnosis, classification, and prognostic factors and presenting the available therapies.
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Affiliation(s)
- Margarida Lima
- Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
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Itoi S, Tanemura A, Hayashi M, Nagata N, Tani M, Katayama I. Transient wheal attack corresponding to the tumor lesions of primary cutaneous diffuse large B cell lymphoma, leg type after successive rituximab treatment. Case Rep Dermatol 2014; 6:218-21. [PMID: 25408649 PMCID: PMC4209260 DOI: 10.1159/000367936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
An elderly male noticed urticarial patches corresponding to cutaneous B cell lymphoma lesions after rituximab treatment. Along with the resolution of urticaria, the lymphoma lesions completely remitted without recurrence. In this communication, we present an interesting case and the pathophysiological findings of a wheal attack in a case with tumor remission following systemic treatment with rituximab, a monoclonal anti-CD20 antibody.
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Affiliation(s)
- Saori Itoi
- Division of Dermatology, Department of Integrated Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Atsushi Tanemura
- Division of Dermatology, Department of Integrated Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Misa Hayashi
- Division of Dermatology, Department of Integrated Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoko Nagata
- Division of Dermatology, Department of Integrated Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mamori Tani
- Division of Dermatology, Department of Integrated Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ichiro Katayama
- Division of Dermatology, Department of Integrated Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
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Fernández-Guarino M, Ortiz-Romero P, Fernández-Misa R, Montalbán C. Rituximab in the Treatment of Primary Cutaneous B-Cell Lymphoma: A Review. ACTAS DERMO-SIFILIOGRAFICAS 2014. [DOI: 10.1016/j.adengl.2014.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ingen-Housz-Oro S, Ortonne N, Chosidow O. Rituximab-related urticarial reaction overlying primary cutaneous follicle centre lymphoma: histological appearance and pathophysiological hypotheses. J Eur Acad Dermatol Venereol 2013; 28:976-8. [DOI: 10.1111/jdv.12313] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 10/09/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - N. Ortonne
- Department of Pathology; AP-HP; Henri Mondor Hospital; Créteil France
- Université Paris-Est Créteil Val de Marne UPEC; Créteil France
| | - O. Chosidow
- Department of Dermatology; AP-HP; Henri Mondor Hospital; Créteil France
- Université Paris-Est Créteil Val de Marne UPEC; Créteil France
- INSERM; Centre d'Investigation Clinique 006; Créteil France
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Fernández-Guarino M, Ortiz-Romero PL, Fernández-Misa R, Montalbán C. Rituximab in the treatment of primary cutaneous B-cell lymphoma: a review. ACTAS DERMO-SIFILIOGRAFICAS 2013; 105:438-45. [PMID: 23540593 DOI: 10.1016/j.ad.2012.10.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Revised: 10/24/2012] [Accepted: 10/25/2012] [Indexed: 11/16/2022] Open
Abstract
Rituximab is a chimeric mouse-human antibody that targets the CD20 antigen, which is found in both normal and neoplastic B cells. In recent years, it has been increasingly used to treat cutaneous B-cell lymphoma and is now considered an alternative to classic treatment (radiotherapy and surgery) of 2 types of indolent lymphoma, namely, primary cutaneous follicle center lymphoma and primary cutaneous marginal zone B-cell lymphoma. Rituximab is also administered as an alternative to polychemotherapy in the treatment of primary cutaneous large B-cell lymphoma, leg type. Its use as an alternative drug led to it being administered intralesionally, with beneficial effects. In the present article, we review the literature published on the use of rituximab to treat primary cutaneous B-cell lymphoma.
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Affiliation(s)
- M Fernández-Guarino
- Servicio de Dermatología, Hospital Central de la Cruz Roja, Universidad Alfonso X El Sabio, Madrid, España.
| | - P L Ortiz-Romero
- Facultad de Medicina, Universidad Complutense, Instituto i+12, Hospital Universitario 12 de Octubre, Madrid, España
| | - R Fernández-Misa
- Servicio de Dermatología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - C Montalbán
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Madrid, España
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Brunet-Possenti F, Franck N, Tamburini J, Jacobelli S, Avril MF, Dupin N. Focal Rituximab-Induced Edematous Reaction at Primary Cutaneous Follicle Center Lymphoma Lesions: Case Report and Literature Review. Dermatology 2011; 223:200-2. [DOI: 10.1159/000332074] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 08/17/2011] [Indexed: 11/19/2022] Open
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Morales AV, Advani R, Horwitz SM, Riaz N, Reddy S, Hoppe RT, Kim YH. Indolent primary cutaneous B-cell lymphoma: experience using systemic rituximab. J Am Acad Dermatol 2008; 59:953-7. [PMID: 18817999 DOI: 10.1016/j.jaad.2008.08.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Revised: 07/31/2008] [Accepted: 08/02/2008] [Indexed: 11/30/2022]
Abstract
BACKGROUND Optimal treatment of indolent primary cutaneous B-cell lymphoma (CBCL), marginal zone lymphoma, and follicle center lymphoma, presenting as multiple lesions, has yet to be established. Rituximab is a chimeric monoclonal IgG1 antibody directed against the CD20 antigen of B cells. Clinical efficacy of systemic rituximab in CBCL has yet to be established. OBJECTIVE We sought to assess the efficacy of systemic rituximab in the treatment of CBCL. METHODS This was a retrospective study of 15 patients with indolent CBCL treated with intravenous rituximab (375 mg/m(2)) as a single agent. Variable maintenance regimen was used in a subset of patients. Responses were categorized as complete response, partial response, stable disease, or progressive disease. The efficacy end points included were objective response rate, time to response, time to progression, and duration of response. RESULTS Ten patients with follicle center lymphoma and 5 with marginal zone lymphoma were included. The objective response rate was 87% (60% complete response, 27% partial response). All patients with follicle center lymphoma had a response with 80% achieving complete response. Of the patients with marginal zone lymphoma, 3 had a response, one stable disease, and one progressive disease. Median follow-up was 36 months. Median time to response, duration of response, and time to progression was 30 days, 24 months, and 24 months, respectively. LIMITATIONS The study was limited by the small sample size and retrospective design. CONCLUSIONS This study, although small, suggests that rituximab is a reasonable first-line treatment option for indolent CBCL with multiple lesions where local treatment is not effective or desirable.
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Affiliation(s)
- Anjali V Morales
- Multidisciplinary Cutaneous Lymphoma Program, Stanford Comprehensive Cancer Center, Stanford, California 94305, USA
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European Organization for Research and Treatment of Cancer and International Society for Cutaneous Lymphoma consensus recommendations for the management of cutaneous B-cell lymphomas. Blood 2008; 112:1600-9. [PMID: 18567836 DOI: 10.1182/blood-2008-04-152850] [Citation(s) in RCA: 266] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Primary cutaneous B-cell lymphomas (CBCL) represent approximately 20% to 25% of all primary cutaneous lymphomas. With the advent of the World Health Organization-European Organization for Research and Treatment of Cancer (EORTC) Consensus Classification for Cutaneous Lymphomas in 2005, uniform terminology and classification for this rare group of neoplasms were introduced. However, staging procedures and treatment strategies still vary between different cutaneous lymphoma centers, which may be because consensus recommendations for the management of CBCL have never been published. Based on an extensive literature search and discussions within the EORTC Cutaneous Lymphoma Group and the International Society for Cutaneous Lymphomas, the present report aims to provide uniform recommendations for the management of the 3 main groups of CBCL. Because no systematic reviews or (randomized) controlled trials were available, these recommendations are mainly based on retrospective studies and small cohort studies. Despite these limitations, there was consensus among the members of the multidisciplinary expert panel that these recommendations reflect the state-of-the-art management as currently practiced in major cutaneous lymphoma centers. They may therefore contribute to uniform staging and treatment and form the basis for future clinical trials in patients with a CBCL.
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Rey J, Wickenhauser S, Ivanov V, Coso D, Gastaut JA, Bouabdallah R. A case of rituximab-related urticarial reaction in cutaneous B-cell lymphoma. J Eur Acad Dermatol Venereol 2008; 23:210. [PMID: 18482321 DOI: 10.1111/j.1468-3083.2008.02792.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Campi P, Benucci M, Manfredi M, Demoly P. Hypersensitivity reactions to biological agents with special emphasis on tumor necrosis factor-alpha antagonists. Curr Opin Allergy Clin Immunol 2008; 7:393-403. [PMID: 17873578 DOI: 10.1097/aci.0b013e3282ef96df] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW Several biological agents have been introduced into the drug market and more are emerging. Adverse reactions to these agents have recently been classified into five different subtypes. Some of these reactions are frequent but without consequences for the patients. Others are less frequent but potentially life-threatening, and they include allergic reactions. RECENT FINDINGS Hypersensitivity reactions are well described adverse drug reactions, corresponding to the ss-type of the newly proposed classification of adverse reactions induced by biological agents. We focus our search on tumor necrosis factor-alpha antagonists, as they represent a dramatic improvement in the therapy of both rheumatic and inflammatory bowel diseases and because adverse reactions have been closely scrutinized. We also add cases from our own experience. We found very few properly documented allergic reactions. SUMMARY Hypersensitivity reactions to tumor necrosis factor-alpha antagonists are not rare. Whether these manifestations have to be considered type beta or type gamma reactions is still a matter of debate. There is a need for allergological tests in vivo and in vitro.
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Affiliation(s)
- Paolo Campi
- Allergy and Clinical Immunology Unit, Nuovo Ospedale San Giovanni di Dio, Florence, Italy
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2007. [DOI: 10.1002/pds.1374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Shuster J. Rituximab Skin Reaction; Skin Hyperpigmentation with Minocycline; Baclofen-Induced Psychosis; Tyrosine Kinase Inhibitors and Hypothyroidism; Myoclonus with Low-Dose Hydromorphone; Hyponatremia with Newest Antidepressant; Lingual Lesions with Orally Disintegrating Risperidone; Quetiapine-Induced Erythema Multiforme Minor. Hosp Pharm 2007. [DOI: 10.1310/hpj4201-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the FDA's medWatch program (800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers. Write to Dr. Shuster at ISMP, 1800 Byberry Road, Suite 810, Huntingdon Valley, PA 19006 (call 215-947-7797; fax 215-914-1492; E-mail: joel.shuster@temple.edu ). Your report will be published anonymously unless otherwise requested. This feature is provided by the Institute for Safe Medication Practices in cooperation with the FDA's medWatch Program and Temple University School of Pharmacy. ISMP is an FDA medWatch partner.
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Graves JE, Nunley K, Heffernan MP. Off-label uses of biologics in dermatology: Rituximab, omalizumab, infliximab, etanercept, adalimumab, efalizumab, and alefacept (Part 2 of 2). J Am Acad Dermatol 2007; 56:e55-79. [PMID: 17190618 DOI: 10.1016/j.jaad.2006.07.019] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2006] [Revised: 06/30/2006] [Accepted: 07/22/2006] [Indexed: 12/28/2022]
Abstract
Recently, dermatologists have witnessed a revolution in our therapeutic armamentarium with the development of several novel biologic immunomodulators. Although psoriasis remains the only condition in dermatology for which the use of biologic immunomodulators has been approved by the Food and Drug Administration, these drugs have the potential to significantly impact the treatment of several inflammatory conditions in dermatology. This article includes a review of the mechanism of action, dosing, and side-effect profile, as well as a review of the current literature on off-label uses of the CD20-positive B-cell antagonist rituximab, the IgE antagonist omalizumab, the tumor necrosis factor-alpha antagonists infliximab, etanercept, and adalimumab, and the T-cell response modifiers efalizumab and alefacept.
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Affiliation(s)
- Julia E Graves
- Division of Dermatology, Washington University, St Louis, Missouri, USA
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