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Rituximab causing deep ulcerative suppurative vaginitis/pyoderma gangrenosum
Priya Selva-Nayagam1, Gayle Fischer, Ian Hamann
1Department of Dermatology, Queen Elizabeth Hospital, Adelaide, Australia, pselva@senet.com.au.
Current Infectious Disease Reports
|April 22, 2015
Summary
Rituximab treatment for B cell non-Hodgkin's lymphoma may cause pyoderma gangrenosum (PG), a rare condition leading to severe vulvovaginal ulcers. This study details six cases, highlighting rituximab as a likely cause.
Area of Science:
- Dermatology
- Gynecology
- Oncology
Background:
- Pyoderma gangrenosum (PG) is a rare ulcerative condition.
- Vulvovaginal PG is exceptionally uncommon, often presenting with severe symptoms.
Purpose of the Study:
- To describe cases of vulvovaginal pyoderma gangrenosum in patients treated with rituximab.
- To investigate the association between rituximab and vulvovaginal PG.
- To review existing literature and differential diagnoses for vulvovaginal PG.
Main Methods:
- Case series of six patients with vulvovaginal PG.
- Review of medical literature on vulvovaginal PG.
- Analysis of clinical presentation and treatment history.
Main Results:
- Six patients (age 50-74) developed vulvovaginal PG while undergoing rituximab therapy for B cell non-Hodgkin's lymphoma.
- Symptoms included severe pain, discharge, and large, deep purulent ulcers extending into the vagina.
- Symptoms persisted for 2-24 months.
Conclusions:
- Rituximab is a potential cause of pyoderma gangrenosum in the vulvovaginal region.
- Early recognition and consideration of rituximab as an etiology are crucial for managing vulvovaginal PG.
- Further research is needed to elucidate the exact mechanism linking rituximab to PG.
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