A Case Study and a Brief Review on Dermatopathological Drug Reaction in Major Thalassemia

Document Type : Case report

Authors

1 Assistant professor, Medical Physicist, Department of Photodynamic Therapy, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran

2 Assistant Professor, Dermatologist, Department of Regenerative Medicine, Royan Institute for Stem Cell Biology &Technology, ACECR, Tehran, Iran

3 Zafar Adult Thalassemia Clinic, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran

4 Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Introduction: Thalassemia consists of a variety of genetic hemoglobinopathies. Thalassemia-major causes anemia in early age. Those suffering from thalassemia need frequent life-long blood transfusions to survive, resulting in iron overload in the body and many health problems. Much improvement has occurred in predicting the course of Thalassemia major thanks to iron chelation therapy. Edible iron chelating agents are the standard of the chelating process. Deferasirox is a newly developed orally active iron chelating tablet which is used on a daily basis. Th present case study investigated severe dermatopathological reactions to the Iranian made product of Deferasirox.
Case presentation: We present a case of adverse drug reactions in a thalassemic patient who was started on Deferasirox orally after receiving Deferoxamine injections for several years with no serious reactions. The patient experiences generalized maculopapular, deep red- blue partially purpuric itchy skin rashes throughout her body. The histopathological biopsy found superficial perivascular or dermatitis with low-grade vasculopathy, few eosinophils, and mild psoriasis form-supraglotticlichenoid epidermal reactions associated with Drug Reaction diagnosis.
Conclusion: With regard to inherent features, caution must be applied to start the original Deferasirox for the patients who will undergo the oral chelation process with a smooth increase in the daily dosage for a few weeks in order to create improved tolerance.

Keywords

Reviews in Clinical Medicine
Volume 10, Issue 3
September 2023
Pages 30-35

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