Pathology: rash from telaprevir

More than 90% of these rashes are mild or moderate, but rash will show up in about half of patients on triple therapy (with or without pruritus).  In clinical trials, 6% require discontinuation of therapy due to rash, and Stevens-Johnson Syndrome has been described.  There are no risk factors associated with rash development. 

A second syndrome to be aware of is DRESS- drug reaction with eosinophilia and systemic symptoms (rash, fever, organ inflammation, lymphadenopathy).  This, along with SJS are grounds for discontinuation of the medication.  Remember, never dose reduce telaprevir. 

Treatment for mild rashes may include oatmeal-based soaps and lotions, topical corticosteroid cream (avoid oral steroids), oral antihistimines, good hydration and sun avoidance. 


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