Palmar Erythema Associated with Natalizumab in a Patient with Multiple Sclerosis

A 38-year-old woman was referred to the Dermatology Outpatient Clinic with an 8-month history of painless, intermittent, self-resolving bilateral palmar erythema (Figures 1&2). Her medical history was significant for Multiple Sclerosis (MS), recurrent urinary tract infection, complex regional pain syndrome of the left leg, and hypertension. She had been receiving monthly natalizumab infusions for the treatment of MS for 13 months. Her only known drug allergy was Penicillin, which resulted in a generalised skin rash.