Zoledronic acid-induced interface dermatitis

Farah Succaria, Mary Collier, Meera Mahalingam

Research output: Contribution to journalArticle


Zoledronic acid (ZA) is a bisphosphonate given intravenously, most commonly for the treatment of postmenopausal osteoporosis. Increase in usage of ZA because it was FDA-Approved has resulted in increasing reports of side effects. For the most part, these are systemic. Cutaneous side effects associated with ZA are infrequent and limited to 2 reports of dermatomyositis to date. In both, patients presented with clinical and laboratory stigmata of dermatomyositis soon after initiation of therapy. In this report, we describe a 62-yearold woman who presented with diffuse, erythematous scaly plaques over the right thigh after 12 hours of infusion of ZA. Histopathologic examination of a skin biopsy from the right thigh revealed patchy scale crust containing neutrophils and inspissated serum, interface change with scattered individually necrotic keratinocytes, and a mild, superficial perivascular lymphocytic infiltrate with scattered eosinophils and pigment incontinence-findings consistent with an interface dermatitis. Given that the patient had no other systemic manifestations or laboratory abnormalities, to the best of our knowledge, ours is the first report of interface dermatitis secondary to ZA with the caveat that longer follow-up is required to definitively exclude the development of drug-induced connective tissue disease.

Original languageEnglish (US)
Pages (from-to)933-935
Number of pages3
JournalAmerican Journal of Dermatopathology
Issue number12
StatePublished - Jan 1 2015
Externally publishedYes


  • interface dermatitis
  • zoledronic acid

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology

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