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Research Articles |
OBJECTIVE: To report a case of skin ulceration as a result of treatment with leflunomide for rheumatoid arthritis. CASE SUMMARY: A 78-year-old white woman developed bilateral leg ulcers after 6 months of treatment with leflunomide for rheumatoid arthritis. A history of leg ulcers after methotrexate therapy had been documented. Serologic and diagnostic tests did not support an alternate process. Other medications prescribed were oral ethinyl estradiol 0.05 mg/d, felodipine 5 mg/d, and paroxetine 20 mg/d, for which no documented correlation with the skin breakdown could be made. DISCUSSION: This is the first published case describing a possible relationship between the use of the immunosuppressant agent leflunomide and skin ulceration. CONCLUSIONS: Skin breakdown and ulceration is a recognized adverse effect of drugs with immunosuppressant activity such as methotrexate. Leflunomide, a newer agent prescribed in the treatment of rheumatoid arthritis, may now be listed among the drugs in this category associated with this adverse drug effect.
This article has been cited by other articles:
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  V. Goeb, J. M. Berthelot, P. Joly, O. Mejjad, J. de Quatrebarbes, C. Reynaud-Hautin, O. Vittecoq, and X. Le Loet Leflunomide-induced subacute cutaneous lupus erythematosus Rheumatology, June 1, 2005; 44(6): 823 - 824. [Full Text] [PDF]
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 D Gensburger, M Kawashima, H Marotte, J Kanitakis, and P Miossec Lupus erythematosus with leflunomide: induction or reactivation? Ann Rheum Dis, January 1, 2005; 64(1): 153 - 155. [Abstract] [Full Text] [PDF]
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