Lymphomatoid papulosis: A cutaneous lymphoproliferative disorder in a patient on fingolimod for multiple sclerosis

Mult Scler. 2016 Jan;22(1):122-4. doi: 10.1177/1352458515597568. Epub 2015 Jul 28.

Abstract

Background: Fingolimod was the first oral disease-modifying treatment for relapsing-remitting multiple sclerosis. It has previously been associated with the development of lymphoma.

Objective: To describe a case of lymphomatoid papulosis, a CD30+ cutaneous lymphoproliferative disorder, in a patient taking fingolimod.

Methods: Case study.

Results: Our patient developed lymphomatoid papulosis 2 months after starting fingolimod. Histology confirmed the diagnosis. The drug was withdrawn. Resolution began only 2 days later.

Conclusions: Lymphomatoid papulosis is a benign subtype of cutaneous T-cell lymphoma, but up to 20% of cases can transform to a malignant course. Patients on fingolimod and physicians caring for them should be mindful of the need to monitor the skin.

Keywords: Adverse effects; case study; fingolimod; lymphoma; lymphomatoid papulosis; multiple sclerosis; risk factor; skin.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Fingolimod Hydrochloride / adverse effects*
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Lymphomatoid Papulosis / chemically induced*
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Skin Neoplasms / chemically induced*

Substances

  • Immunosuppressive Agents
  • Fingolimod Hydrochloride