[Bortezomib-induced eruption: Sweet syndrome? Two case reports]

Area of Science:

• Dermatology
• Oncology
• Pharmacology

Background:

• Bortezomib (Velcade) is a proteasome inhibitor used for myeloma and other blood cancers.
• Cutaneous side effects of bortezomib are common, but specific presentations can vary.

Observation:

• Two patients receiving bortezomib developed distinct toxic rashes.
• One patient experienced giant oral mucous membrane ulcerations alongside a papulonodular rash.
• Histological analysis revealed neutrophilic dermal infiltrates and oral mucosal inflammation.

Findings:

• The observed skin and oral lesions were suggestive of Sweet's syndrome and neutrophilic dermatosis.
• Lesions in both patients resolved after bortezomib discontinuation or with specific treatments like colchicine or dexamethasone.
• This report highlights the potential for bortezomib to induce Sweet's syndrome-like reactions, including rare oral ulcerations.

Implications:

• Clinicians should be aware of bortezomib's potential to cause Sweet's syndrome and severe oral ulcerations.
• Prompt recognition and management of these adverse events can prevent treatment interruption.
• Further research into bortezomib-induced neutrophilic dermatoses is warranted.