CASE REPORT - Arava-associated skin ulceration

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The ls of Pharmacotherapy: Vol. 36, No. 6, pp. 1009-1011. DOI

10.1345/aph.1A347

© 2002 Harvey Whitney Books Company.

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Leflunomide-associated skin ulceration

CM McCoy

OBJECTIVE: To report a case of skin ulceration as a result of treatment with

leflunomide for rheumatoid arthritis. CASE SUMMARY: A 78-year-old white

woman developed bilateral leg ulcers after 6 months of treatment with

leflunomide for rheumatoid arthritis. A history of leg ulcers after

methotrexate therapy had been documented. Serologic and diagnostic tests did

not support an alternate process. Other medications prescribed were oral

ethinyl estradiol 0.05 mg/d, felodipine 5 mg/d, and paroxetine 20 mg/d, for

which no documented correlation with the skin breakdown could be made.

DISCUSSION: This is the first published case describing a possible

relationship between the use of the immunosuppressant agent leflunomide and

skin ulceration. CONCLUSIONS: Skin breakdown and ulceration is a recognized

adverse effect of drugs with immunosuppressant activity such as

methotrexate. Leflunomide, a newer agent prescribed in the treatment of

rheumatoid arthritis, may now be listed among the drugs in this category

associated with this adverse drug effect.

http://www.theannals.com/cgi/content/abstract/36/6/1009

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s Hopkins Medicine

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