Delayed-onset cutaneous eruption associated with lenalidomide in setting of multiple myeloma

Area of Science:

• Dermatology
• Oncology
• Pharmacology

Background:

• Lenalidomide (LEN) is a crucial therapy for multiple myeloma (MM).
• Cutaneous adverse reactions to LEN are common, typically appearing within one month of treatment initiation.
• Prompt recognition and management of these reactions are vital for MM patient care.

Observation:

• This report details a rare case of a delayed-onset lenalidomide-associated eruption.
• The patient presented with a skin reaction over three years after commencing LEN therapy.
• Histopathologic findings of this delayed eruption are also described.

Findings:

• Lenalidomide-associated eruptions can manifest with a significant delay, extending beyond the typical one-month timeframe.
• Histopathologic examination provides insights into the nature of these delayed cutaneous reactions.
• The case underscores the need for vigilance regarding LEN's dermatologic side effects.

Implications:

• Dermatologists must consider the possibility of delayed lenalidomide-induced skin reactions in MM patients.
• Awareness of delayed presentations is crucial for accurate diagnosis and appropriate management.
• This case contributes to understanding the spectrum of adverse cutaneous reactions to lenalidomide.