PRIDE complex-like skin rash associated with bevacizumab.

Area of Science:

• Neuro-oncology
• Dermatology
• Pharmacology

Background:

• Bevacizumab is used to treat brain edema following stereotactic radiosurgery for arteriovenous malformations.
• Bevacizumab-induced rash is a rare but reported side effect.
• Insights into its management and relationship with efficacy are limited.

Observation:

• A patient with occipital arteriovenous malformation developed steroid-resistant brain edema post-radiosurgery.
• Partial response to bevacizumab was noted, but a papulopustular rash emerged.
• The rash recurred upon reintroduction of bevacizumab at doses above 7.5 mg/kg.

Findings:

• The bevacizumab-induced rash appeared to be dose-dependent.
• Local and oral treatments were initiated for the rash.
• Reducing the bevacizumab dose to 5 mg/kg prevented rash recurrence and resolved edema.

Implications:

• Bevacizumab therapy does not necessarily need to be halted due to rash.
• Dose modification of bevacizumab can allow for continued treatment.
• This suggests a potential strategy for managing bevacizumab-induced dermatologic complications.