Wednesday, 2 August 2017

#ClinicSpeak: altered skin pigmentation after pegylated interferon

Are you on an injectable? Do you have altered skin pigmentation? #ClinicSpeak #MSBlog

The following case report of altered skin pigmentation in response to pegylated interferon-beta-1a (Plegridy) is interesting. The is a potential mechanism in that interferon increases the expression of a receptor, called alpha-melanocyte-stimulating hormone (MSH), on the surface of cells. As PEG-IFN-beta has such a long plasma half-life it may even increase incidence for such cutaneous side effects particularly in dark-skinned patients. However, this mechanism does not explain why this person has depigmentation in the legs. 

If you are a pwMS on interferon and have a similar problem we would be interested in hearing from you. You can email us  at and it would be great if you can send us some pictures as well. Thank you. 

Coghe et al. Localized pigmentation disorder after subcutaneous pegylated interferon beta-1a injection. Mult Scler. 2017 Jul 1:1352458517708465.

We report the case of a 42-year-old female patient who developed peculiar skin lesions due to subcutaneous polyethylene glycol (PEG) interferon beta-1a. The dermatological examination showed hypochromic macules that had coalesced into a 10-cm-diameter patch. On the abdomen injection sites, there was a greyish diffuse hyperpigmentation arranged irregularly in annular macules. Fungal infection, vitiligo and pityriasis alba were excluded. After 6 months, the lesions had worsened. This is the first case of localized pigmentation disorder reported with interferon beta, and while the clinical findings are not ascribable to vitiligo or interferon-related facial/mucosal hyperpigmentation, they may partially share the underlying mechanisms. 

Figure from the MSJ.

Hyperpigmentation has been associated with use of pegylated interferon alpha suggesting a common mechanism. 

No comments:

Post a Comment

Please note that all comments are moderated and any personal or marketing-related submissions will not be shown.