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Disease modifying agent related skin reactions in multiple sclerosis: prevention, assessment, and management

Department of Neurology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA, Department of Radiology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA, elliot.frohman{at}utsouthwestern.edu

K Brannon

Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

Sherry Alexander

Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

D Sims

Department of Radiology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

J T Phillips

Baylor University Medical Center, Dallas, TX, USA

S O'Leary

Baylor University Medical Center, Dallas, TX, USA

K Hawker

Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

M K Racke

Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA, the Center for Immunology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

Background: The objective for this article is to highlight some of the adverse skin manifestations associated with injectable disease modifying therapy for multiple sclerosis (MS). Early identification and intervention can often lead to minimal consequences and prolonged patient tolerance and compliance with these agents. A t the University of Texas Southwestern Medical C enter at Dallas and Texas Neurology in Dallas we actively follow appro ximately 5000 MS patients. The majority of our patients with relapsing-remitting MS (RRMS) or secondary progressive MS (SPMS) are treated with one of the currently available disease modifying agents (DMA s). O ur experience with these patients, and the challenges they face in continuing long-term treatment, constitutes the basis of our proposed treatment strategies. Conclusion: Skin reactio ns in response to injectable DMA therapy in MS are generally mild. However, some reactio ns can evolve into potentially serious lesions culminating in infection, necro sis, and in some circumstances requiring surgical repair.

Key Words: abscess • erythema • glatiramer acetate • interferon beta • necrosis

Multiple Sclerosis, Vol. 10, No. 3, 302-307 (2004)
DOI: 10.1191/1352458504ms1002oa


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