Bullae And Blisters: A Rare Case of Bendamustine Skin Toxicity

Excerpt

A-67-year old male was evaluated for unremitting fever of 6 months duration. Clinical examination revealed anaemia, hepatosplenomegaly and generalised lymphadenopathy. Lymph nodal biopsy and bone marrow examination showed features suggestive of mantle cell lymphoma (MCL). In view of poor performance status and old age, he was started on Bendamustine–Rituximab (BR) regimen (B-90 mg/m² × 2 days and R-375 mg/m²). During the 1st cycle, after infusion of bendamustine, patient started developing skin lesions in the form of flaccid to tense blisters and bullae over an erythematous background, proximal to injection site on left hand (Fig. 1a, b). Lesions did not involve any other part of body. Eruptions were not associated with pruritus or fever and did not progress proximal to elbow joint. In the following week, lesions resolved on its own without any medication. The lesions reappeared soon after 2nd cycle in the similar pattern and subsided successively. As the patient did not develop any life threatening adverse events related to bendamustine, patient is being planned for 3rd cycle under close observation.

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