Cutaneous adverse events related to glatiramer acetate injection (copolymer‐1, Copaxone^®)

Abstract

Conservative partial resection of the mass (glossectomy) is the prescribed treatment. We report this case, firstly, due to the severity of the associated symptoms (restriction of the aerodigestive tract), and secondly, due to the rarity of this phenomenon. We believe that BSLT is a rare anatomic location of symmetrical benign lipomatosis (Madelung's disease).

Cutaneous adverse events associated with disease-modifying treatment in multiple sclerosis: a systematic review

“…Embolia cutis medicamentosa, however, seems to be the only exception as it is associated with the injection itself rather than with the drug injected. 79,121 Based upon the results of our literature review lipoatrophy seemed more frequently reported in association with GA in comparison to the other DMTs. A majority of the cases with lipoatrophy were linked to GA.…”

“…Most theories focus on immune-mediated mechanisms, including local inflammatory reactions, IgE-mediated reactions, delayed hypersensitivity reactions and other immune reactions. 121 Buttmann and colleagues showed that SC IFN-β is able to induce local chemokine production, which can lead to inflammatory skin reactions. 122 Consistent with this, several of the reported cutaneous adverse events have an immune-mediated pathogenesis, such as psoriasis and vasculitis.…”

IgE‐mediated hypersensitivity reaction and desensitization to glatiramer acetate in a pediatric patient

“…These reactions are thought to be due to direct mast cell activation at the site of injection causing the release of histamine and other mediators. Other reactions localized to the skin have also been described and thought to be caused by either direct drug toxicity (skin necrosis, lobular panniculitis) or immunomodulation (erythema nodosum, urticarial vasculitis) (3). About 10% of patients are reported to experience an immediate postinjection systemic reaction (IPISR) characterized by flushing, chest pain, anxiety, subjective sensation of dyspnea, and throat constriction.…”

“…The diagnosis of CM allergy is based on clinical history, positive skin prick test (SPT) and/or specific IgE, and a positive oral food challenge (OFC) (2). The OFC is the gold standard for diagnosing, but the decision to perform it is complex (3). Many factors including the possibility of severe systemic reactions, medical records, SPT, and specific IgE levels must be taken into account when deciding to carry out it.…”

Case Report: Two Cases of Nicolau Syndrome Associated with Glatiramer Acetate

“…2 The spectrum of GA-associated dermatologic events includes localized injection-site reactions (ISRs) with pain, erythema, and induration; less commonly, lipoatrophy and panniculitis; and rarely, skin necrosis. 3 Herein, we report two cases of Nicolau syndrome associated with GA therapy. One patient required prompt surgical intervention and wound care, and the other was treated conservatively before eventual wound debridement.…”