Journal of Research in Pharmacy Practice

Multiple cutaneous necrotic lesions associated with Interferon beta-1b injection for multiple sclerosis treatment: A case report and literature review

Authors

. Gita Faghihi 1
. Akram Basiri 1
. Mohsen Pourazizi 2
. Bahareh Abtahi-Naeini 3
. Ali Saffaei 4

1 Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Students' Research Committee, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran

3 Department of Dermatology, Skin Diseases and Leishmaniasis Research Center, Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

4 Pharmacy Students’ Research Committee, School of Pharmacy, Isfahan University of Medical sciences, Isfahan, Iran

Abstract
Multiple sclerosis (MS) is a chronic and debilitating inflammatory autoimmune disorder of the 
central nervous system. MS patients may experience severe local inflammatory skin reactions 
during disease-modifying therapy with subcutaneously injected interferon-beta-1b (IFN-β). 
We report the case of a 49-year-old woman with relapsing-remitting MS, who developed 
multiple cutaneous necrotic ulcers on both arms and thighs after 3 months of treatment with 
subcutaneous IFN-β-1b. The biopsy specimens showed skin and subcutaneous tissue necrosis. 
We diagnosed the skin lesions as cutaneous necrotic ulcerations associated with IFN-β-1b 
injection. The treatment included ending the use of subcutaneously injected IFN-β-1b and 
switching to intramuscularly injected IFN-β-1a because of the multiple cutaneous necrotic 
ulcers. The injection of IFN-β-1b in the areas with lesions was stopped, and the patient’s 
clinical condition improved with the addition of routine wound care, surgical debridement, 
and skin grafting. This report is intended to raise awareness about severe adverse skin 
reactions which may rarely occur with subcutaneous IFN-β-1b injection. Early recognition 
and correction of the injection technique and switching to other forms of interferon can 
help to prevent these complications.

Keywords

Interferon beta-1b
multiple sclerosis
necrotic cutaneous ulcer
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Journal of Research in Pharmacy Practice
Volume 4, Issue 2
Spring 2015
Pages 99-103

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