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Persistent Diffuse Telangiectatic Eruption Associated With Loncastuximab Tesirine.

Sarah John1, Briana Heinly2, Klaus Helm2

  • 1Penn State College of Medicine, Hershey, PA; and.

The American Journal of Dermatopathology
|June 26, 2026
PubMed
Summary
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Loncastuximab tesirine (LT), a lymphoma treatment, can cause a persistent telangiectatic eruption. This vascular skin reaction, though minimally inflammatory, may not respond well to standard treatments.

Area of Science:

  • Oncology
  • Dermatology
  • Pharmacology

Background:

  • Loncastuximab tesirine (LT) is an approved CD19-directed antibody-drug conjugate for relapsed/refractory diffuse large B-cell lymphoma.
  • Adverse cutaneous reactions to antibody-drug conjugates (ADCs) are increasingly recognized.
  • Telangiectatic eruptions represent a distinct, recently identified potential side effect of ADCs.

Purpose of the Study:

  • To report a case of a persistent, diffuse telangiectatic eruption following loncastuximab tesirine initiation.
  • To describe the histopathologic features of this specific skin reaction.
  • To emphasize the importance of recognizing this adverse effect due to its persistence and limited treatment response.

Main Methods:

  • Clinical observation of a patient developing a skin eruption after LT treatment.
Keywords:
antibody–drug conjugateloncastuximab tesirinetelangiectatic eruptiontoxicity

Related Experiment Videos

  • Dermatopathologic examination of skin biopsy specimens.
  • Review of existing literature on ADC-associated cutaneous reactions.

    • Main Results:

    • The patient developed a diffuse telangiectatic eruption shortly after starting LT.
    • Histopathology showed epidermal thinning, superficial ectatic vessels, prominent fibroblasts, solar elastosis, and dermal melanophages.
    • The eruption was minimally inflammatory and vascular-predominant.
    • The reaction persisted after LT cessation and showed limited response to corticosteroids.

    Conclusions:

    • Loncastuximab tesirine can induce a unique, persistent telangiectatic eruption.
    • This vascular reaction pattern is an important, recently recognized adverse effect of ADCs.
    • Awareness of this specific morphology is crucial for clinicians managing patients on ADCs, considering its persistence and treatment challenges.