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Updated: May 23, 2025
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Granulocyte-dependent Autoantibody-induced Skin Blistering
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Azacitidine-induced bullous pemphigoid-like localized toxic reaction
Rodrigo Brêtas Emerich Nogueira1, Nelson Hidekazu Tatsui1, Laura Ramos de Almeida2
1Department of Hematology, Hemotherapy and Cell Therapy, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Einstein (Sao Paulo, Brazil)
|March 7, 2025
Summary
Azacitidine effectively treats myelodysplastic syndromes. A rare skin reaction occurred with subcutaneous azacitidine, suggesting intravenous administration may reduce such toxicities.
Area of Science:
- Hematology
- Oncology
- Dermatology
Background:
- Azacitidine is a key hypomethylating agent for high-risk myelodysplastic syndromes (MDS).
- Allogeneic stem cell transplantation (allo-SCT) is a curative option but not suitable for all MDS patients.
Observation:
- A patient with MDS, ineligible for allo-SCT, developed a rare cutaneous side effect.
- The side effect, a bullous pemphigoid-like reaction, emerged after subcutaneous azacitidine administration.
Findings:
- This case highlights a previously unreported cutaneous toxicity associated with subcutaneous azacitidine.
- The observed reaction was localized and bullous pemphigoid-like.
Implications:
- Switching azacitidine administration from subcutaneous to intravenous may mitigate localized toxic skin reactions.
- Further investigation is warranted to confirm the efficacy of intravenous azacitidine in preventing such side effects in MDS patients.
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