Pityriasis rosea-like eruption induced by omalizumab: a case report of a rare side effect
Abstract
Background Omalizumab is a monoclonal humanized antibody used as a third-line treatment for chronic spontaneous urticaria (CSU). While it has shown significant efficacy in controlling urticaria symptoms, it is also associated with various adverse effects. Cutaneous side effects of omalizumab have been reported, but the mechanisms underlying these reactions are not fully understood. This case report describes a patient who developed a maculopapular rash after receiving the 8th dose of omalizumab, which has not been previously reported. Case Description The patient in this case was a 46-year-old male with CSU who had been receiving omalizumab injections every four weeks. After the 8th dose, he developed a generalized itchy erythematous skin eruption six days after the injection. The rash progressively worsened over a two-week period. Interestingly, the patient had experienced a milder skin reaction after the 6th dose, which resolved on its own. A skin biopsy showed mild interstitial edema in the dermis with a mild perivascular infiltrate of lymphocytes and eosinophils, consistent with a drug-induced eruption. The patient was advised to hold the next dose of omalizumab and was managed with topical steroids. Significant improvement and resolution of the lesions were observed, and no recurrence or relapse was reported after the patient resumed omalizumab. Conclusions This case adds to the existing literature by reporting a pityriasis rosea-like eruption as an adverse reaction to…
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