Case report
Lichenoid rash: A new side effect of oral Cladribine

https://doi.org/10.1016/j.msard.2020.102023Get rights and content

Highlights

Abstract

Cladribine is an approved drug for the treatment of highly active multiple sclerosis. We report a 28-years-old man with a poor response to previous treatments, elected to treatment with Cladribine. He developed a lichenoid rash two weeks after taking the first and second treatment cycles. This symptom regressed with specific therapy. A lichenoid drug eruption is a rare side effect which can occur following the administration of several different medications, but it has never been described after treatment with oral Cladribine.

Section snippets

Background

Multiple sclerosis (MS) is an inflammatory neurodegenerative disease of the central nervous system. Several disease modifying treatment (DMTs) for MS can be associated with a wide spectrum of cutaneous adverse events, the most frequently reported being lipoatrophy, cutaneous necrosis and ulcers, and various immune-mediated inflammatory skin diseases, which may influence treatment adherence and patient quality of life.

Cladribine (2-chlorodeoxyadenosine) is an old chemotherapeutic and

Case report

We report a 28-year-old man with RRMS who presented an inadequate response to previous first and second line disease modifying treatments. In the last year, patient presented two relapse and his EDSS score increased from 1.5 to 3.0. Relapses have been treated with intravenuos steroids and non-pharmacological treatments (tDCS and TMS) were applied in an attempt to recover disability (Iodice et al., 2015, Iodice et al., 2017). Successively he underwent to cladribine treatment (Mavenclad®, each

Discussion

Herein we present a case of lichenoid drug eruption caused by oral Cladribine. This diagnosis was made on the basis of history and physical exam findings, thanks to temporal relationship between drug administration and symptoms onset, but skin biopsy was not performed because patient refused. The typical clinical features to diagnose a drug related lichenoid rash were present: violaceus scaly and flat-topped papules were present; Wickham striae were absent; nail and mucous membrane involvement

Declaration of Competing Interest

Authors reported no disclosures

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