Cutaneous reactions to apremilast are rare. This case report describes a patient who experienced purpura annularis telangiectodes of Majocchi (PATM) as an adverse event associated with apremilast, a phosphodiesterase (PDE)-4 inhibitor used in the treatment of psoriasis.
A man in his 60s with a history of psoriasis and psoriatic arthritis developed numerous annular petechial patches after starting apremilast treatment. He had been diagnosed with psoriasis about 7 years earlier and had been treated with efalizumab, adalimumab, etanercept, and ustekinumab. After 4 months of standard dosing with apremilast, he developed telangiectatic patches on his abdomen, arms, and thigh (Figure 1) of 3 weeks’ duration at the time of presentation.
Jaclyn A. Kalik, Harvey Friedman, Mark A. Bechtel, Alejandro A. Gru, Benjamin H. Kaffenberger. Purpura Annularis Telangiectodes of Majocchi Associated With the Initiation and Rechallenge of Apremilast for Psoriasis Vulgaris. JAMA Dermatol. 2017;153(11):1197–1198. doi:10.1001/jamadermatol.2017.2671