Skin Rashes Research Today is a free monthly online journal that collates and summarizes the latest research about Skin Rashes, including details on dermatitis, itches, creams, medication, treatment.

Interstitial granulomatous drug reaction to anakinra.

Regula CG, Hennessy J, Clarke LE, Adams DR, Ioffreda MD, Graber EM, Helm KF

Department of Dermatology, Milton S. Hershey Medical Center, Penn State University College of Medicine, Hershey, Pennsylvania, USA. cregula@hmc.psu.edu

Interstitial granulomatous drug reactions are an uncommon entity presenting as asymptomatic, annular, erythematous to violaceous plaques. The incidence of such reactions has been increasing with the use of biologic agents. We report, to the best of our knowledge, the first such reaction to the interleukin (IL)-1 inhibitor anakinra. Our patient presented with pink dermal plaques and nodules in the periaxillary region which resolved with discontinuation of anakinra and recurred upon restarting anakinra. Biopsy revealed a diffuse dermal infiltrate of lymphocytes and histiocytes with interspersed neutrophils and eosinophils. Fragmentation and degeneration of collagen and elastic fibers was also present. Withdrawal of anakinra led to complete resolution of the lesions. Interstitial granulomatous drug reactions are increasing in frequency and we add anakinra to the list of causative agents.

Published 15 July 2008 in J Am Acad Dermatol, 59(2): S25-7.
Full-text of this article is available online (may require subscription).

© 2004-2008 Skin Rashes Research Today. All Rights Reserved.