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Title of Journal: Int J Hematol

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Abbravation: International Journal of Hematology

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Springer Japan

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1865-3774

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Generalized purpuric drug exanthem with hemorrhagi

Authors: Aruna Gavini Gladys H Telang Adam J Olszewski
Publish Date: 2012/01/31
Volume: 95, Issue: 3, Pages: 311-314
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Abstract

A 72yearold woman presented with dyspnea and lower extremity edema Extreme lymphocytosis cytopenia and splenomegaly were found and she was diagnosed with Bprolymphocytic leukemia Following the first dose of therapy with bendamustine the patient developed severe generalized maculopapular rash which subsequently progressed to exuberant nonblanching palpable purpura with hemorrhagic plaques suspicious for leukocytoclastic vasculitis These events coincided with severe chemotherapyinduced neutropenia and thrombocytopenia but there were no clinical symptoms of infection Skin punch biopsy revealed perivascular and diffuse upper dermal lymphocytic infiltrate with eosinophils and marked erythrocyte extravasation consistent with a purpuric drug exanthem The patient was treated with steroids with complete resolution of the findings This new form of cutaneous toxicity of bendamustine is presented along with a review of previous experience with the drug

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