Objective: To present the case of a woman with Parkinson’s disease (PD) who developed pemphigoid-like skin lesions after being started on safinamide therapy.

Background: Safinamide is a monoamine oxidase B inhibitor and glutamate release inhibitor that is recommended by the International Parkinson and Movement Disorder Society for the treatment of motor fluctuations in PD. Because the drug was marketed relatively recently, it is possible that some adverse events linked to its use may not have been reported yet.

Method: Case report.

Results: A 72-year-old woman had been suffering from PD for 6 years. Her medication consisted of levodopa/carbidopa, pramipexole, domperidone and rasagiline. She also took medication for conditions other than PD. She also had a history of bullous pemphigoid, which had been quiescent for years, without any active skin lesions or on-going therapy.
As the patient was experiencing severe dyskinesia and motor fluctuations, we elected to replace rasagiline by safinamide, while leaving the other drugs unchanged. A few weeks after starting taking safinamide, she noted the appearance of tense reddish itchy blisters of about 1 cm diameter covering her whole body, akin to those she had experienced years before. Mucosae were spared. She was seen by a dermatologist and a clinical diagnosis of bullous pemphigoid was made. Topical corticosteroids were prescribed. When she informed us of the situation, we considered safinamide as a possible causative agent and stopped it. The itchy bullous lesions healed over approximately 2-3 months following discontinuation of safinamide and did not recur, although red lesions where the blisters were located have remained.

Conclusion: We have presented the case of a woman who developed a bullous skin condition, diagnosed as drug-induced bullous pemphigoid by a dermatologist. Whereas no histopathological examination was performed to confirm the diagnosis, it nevertheless raises the possibility that safinamide may cause drug-induced pemphigoid, at least in some individuals who previously have had this condition. Further case reports like this one, with histopathological confirmation, are necessary to confirm this possibility. Meanwhile, clinicians should be aware that safinamide may lead to bullous skin lesions akin to bullous pemphigoid and adjust their treatment accordingly.

« Back to 2022 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/bullous-skin-lesions-following-introduction-of-safinamide-in-a-woman-with-parkinsons-disease/