Authors
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
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