Images in Clinical Medicine

Bortezomib-Induced Skin Lesions

Mariëtte J. Agterof, M.D., and Douwe H. Biesma, M.D., Ph.D.

N Engl J Med 2005; 352:2534June 16, 2005

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A 62-year-old woman had progression of multiple myeloma despite many therapies, including an autologous hematopoietic stem-cell transplantation. Infusions of bortezomib (1.3 mg per square meter of body-surface area) were administered as an intravenous bolus twice weekly for 2 weeks, followed by a 10-day rest period. During the second treatment cycle, a purpuric rash, which was not associated with fever or itching, developed on the patient's trunk, back, hands, and face. A biopsy specimen of the skin lesion revealed a leukocytoclastic vasculitis. The patient was treated with 20 mg of prednisone, and the rash resolved. The rash recurred with subsequent cycles of bortezomib treatment. Bortezomib is a member of a new class of antineoplastic agents that inhibit the proteasome and is being studied as a form of therapy for a wide variety of cancers.

Mariëtte J. Agterof, M.D.
Douwe H. Biesma, M.D., Ph.D.
St. Antonius Ziekenhuis, 3435 CM Nieuwegein, the Netherlands

Citing Articles (13)

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