Reticular Skin Rash as an Adverse Effect of 5-Azacitidine

Abstract

Azacitidine is a hypomethylating agent used for the treatment of patients with myelodysplastic syndrome (MDS). It has been approved by the Food and Drug Administration (FDA) and the European Medicines Agency for the treatment of MDS and is also indicated for the treatment of acute myeloid leukemia (AML). Injection site erythema, ecchymosis, and petechiae are some of the common cutaneous adverse reactions associated with azacitidine. This article describes a rare adverse cutaneous drug reaction with azacitidine in the form of a reticular generalized skin rash in a 28-year-old female with AML.

Keywords: acute myeloid leukemia; adverse cutaneous drug reaction; azacitidine; generalised skin rash; reticular rash.

Figure 1. Multiple erythematous-to-violaceous reticular maculopapular lesions over bilateral legs.

Figure 2. Biopsy section shows keratinized stratified squamous epithelium with an underlying sub-epithelial zone of necrosis and collagenolysis (hematoxylin & eosin, 100×).