Bortezomib-Induced Skin Lesions

A 62-year-old woman had progression of multiple myeloma despite many therapies, including an autologous hematopoietic stem-cell transplantation. Infusions of bortezomib (1.3 mg per square meter of body-surface area) were administered as an intravenous bolus twice weekly for 2 weeks, followed by a 10-day rest period. During the second treatment cycle, a purpuric rash, which was not associated with fever or itching, developed on the patient's trunk, back, hands, and face. A biopsy specimen of the skin lesion revealed a leukocytoclastic vasculitis. The patient was treated with 20 mg of prednisone, and the rash resolved. The rash recurred with subsequent cycles . . .