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Lenalidomide is an immunomodulator analog of thalidomide used in the treatment of hematologic malignancies, both with previous reports of hypersensitivity reactions. Desensitization protocols with lenalidomide are not established and few are published. Therefore, we describe a clinical case of a 70-year-old male patient under monthly cycles of lenalidomide referred to our Allergy department due to generalized maculopapular exanthema appearing on the 16th day of the 3rd cycle of treatment.
After treatment with systemic and topical corticosteroid for 1 week, resolution of all lesions was present on the following 2 weeks. A slow desensitization protocol was performed after a risk-benefit assessment, with tolerance, although patient needed to decrease its daily dose as exanthema appearance seemed to be dose-dependent.
Description and publication of cases with desensitization procedures in late reactions is relevant, especially in cases where T-mediated hypersensitivity reactions as well as dose-dependent mechanisms are described.
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