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Necrotizing skin lesions and NA Bs development in a multiple sclerosis patient treated with IFNß 1b

Clinica Neurologica, Policinico, Via Del Pozzo 71, 41100 Modena, Italy, merelli.e{at}policlinico.mo.it

Elisa Merelli

Clinica Neurologica, Policinico, Via Del Pozzo 71, 41100 Modena, Italy

Roberta Bedin

Clinica Neurologica, Policinico, Via Del Pozzo 71, 41100 Modena, Italy

Alessandro Martella

Clinica Dermatologica, Via Del Pozzo 71, 41100 Modena, Italy

Anna Cesinaro

Dipartimento di Anatomia Patologica, Via Del Pozzo 71, 41100 Modena, Italy

Antonio Bertolotto

Laboratorio di Neurobiologia, Ospedale San Luigi Orbassano, Via Regione Gondole 10, 10043 Torino, Italy

A case of a severe necrotizing vasculopathic skin lesions occurred in a 43 year old women affected by multiple sclerosis (MS) submitted to IFNb-lb has been described. A fter two months of therapy the patient presented, in injection sites of the abdomen, arms and legs, numerous ulcers. A biopsy of the lesions was performed and evidenced confluent necro sis of the superficial and deep skin tissue with mild infiltration by inflammatory cells and thrombosis in deep blood vessels. The IFNb-lb was immediately discontinued and therapy with corticosteroids was started. A fter 12 months from the onset of the adverse reaction, the skin vasculopathic lesions cicatrised leaving sclerotic areas on the abdomen. Neutralizing antibodies against IFNb-lb (NA Bs) were strongly positive at the onset of the skin ulcers and slowly decreased until the recovery. A possible role of NA Bs in the development of the skin lesions has been considered.

Key Words: IFNß-lb • multiple sclerosis • NABs • skin ulcers

Multiple Sclerosis, Vol. 9, No. 4, 420-423 (2003)
DOI: 10.1191/1352458503ms933sr


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