2022 Volume 21 Issue 4 Pages 295-299
A 61-year-old man presented with severe edematous, urticarial erythema on his face, neck, and trunk after two courses of combination therapy for multiple myeloma with bortezomib, lenalidomide,and dexamethasone (VRD). After the first course of the therapy, he had presented with pruritic erythema and eosinophilia, which improved on topical corticosteroid therapy. The clinical symptoms resolved by administration of anti-allergy drug ; however, they got worse after the beginning of the third course of VRD therapy. Biopsy specimen revealed slight dermal edema and perivascular infiltration of eosinophils without vasculitis ; therefore, we diagnosed as angioedema induced by lenalidomide. After the withdrawal of lenalidomide and administration of oral prednisolone (15 mg/day), clinical symptoms and eosinophilia improved quickly. To our knowledge,cases of angioedema induced by lenalidomide are extremely rare and only six cases have been reported so far. The pathogenesis of angioedema has not been clarified yet, but it has been suggested that the cytokines from eosinophils and IgE-mediated reaction may be involved in the process of induction of angioedema. Further clinical studies based on the accumulation of cases should explore the pathogenesis of this disease. Skin Research, 21 : 295-299, 2022
