The rate of metastatic melanoma following negative SLNB at long-term follow-up at the ORCC is higher than the upper limit of rates reported in the literature (6%-24%). The reason for this is multifactorial, and the long follow-up period of 5 years allowed for detection of metastatic disease at a mean of 3.9 years. Long-term prognosis may be guarded in node-negative patients with a primary cutaneous melanoma, and surveillance by a multidisciplinary team is crucial.
The purpose of this study was to firstly present the maiden case of tamoxifen-induced acute cutaneous lupus erythematosus (ACLE), and secondly, to broaden the discussion into a systematic review of the various tamoxifen-related skin changes documented in patients with breast cancer. We searched PubMed, Cochrane, Embase, CancerLit, Scopus, Web of Science, and Google Scholar databases using keywords to identify reported cases of tamoxifen-related cutaneous adverse events. Outcomes captured included type of cutaneous reaction, time to adverse event, pathologic mechanism, and possible treatment. From 17 clinical studies identified, over ten distinct types of adverse reactions of the skin were itemized. The character of these cutaneous events ranged from the relatively common hot flashes to the rare, but potentially life-threatening, Steven Johnson syndrome. Overall, tamoxifen is generally a well-tolerated hormone therapy with decades of supporting safety data. Based on current medical literature, we present the first case of tamoxifen-induced ACLE. Our clinical experience of managing this case revealed that despite its broad use and the frequency of associated skin reactions, there is a lack of concise information detailing the cutaneous adverse events associated with tamoxifen. The absence of summarized information concerning tamoxifen-related skin changes prompted us to perform a review herein.
Background: Cutaneous T-cell pseudolymphoma (CTPL) is a benign reactive T-cell lymphoproliferative subtype of pseudolymphoma.Some variants of CTPL can resemble the plaques of mycosis fungoides (MF). The vast majority of drug-induced cases have been associated with anticonvulsants. There is only one report in the literature documenting a case of vancomycin-induced CTPL.Methods: We report a cutaneous T-cell lymphoma-like eruption in a human immunodeficiency virus (HIV)-positive patient recently started on vancomycin and rifampin.Results: A skin biopsy showed several histologic features of MF with immunohistochemical and T-cell receptor gene rearrangement studies suggestive of CTPL. This atypical T-cell reaction mimicking MF completely resolved on cessation of rifampin followed by vancomycin.Conclusion: Considering drug-induced causes of MF-like histologic changes is crucial to prevent unnecessary treatment for MF.Contexte: Le pseudolymphome T cutané (PLTC) est un sous-type lymphoprolifé ratif bé nin de pseudolymphome à lymphocytes T ré actifs. Certaines variantes du PLTC peuvent ressembler aux plaques de mycose fongoïde (MF). La plupart des cas provoqué s par les mé dicaments sont associé s aux anticonvulsivants. La documentation sur le sujet ne fait é tat que d'un seul cas de PLTC causé par la vancomycine.Mé thode: Sera dé crit ici un cas d'é ruption de lé sions semblables à celles du lymphome T cutané chez une porteuse du virus de l'immunodé ficience humaine (VIH), traité e depuis peu par la vancomycine et la rifampine.Ré sultats: Une biopsie de la peau a ré vé lé plusieurs aspects histologiques de la MF, à l'aide d'analyses immunohistochimiques et d'analyses de ré arrangement gé né tique des ré cepteurs de l'antigè ne des lymphocytes T, é vocateurs d'un PLTC. Cette ré action atypique des lymphocytes T simulant une MF est disparue complè tement avec l'arrê t de la rifampine, suivi de celui de la vancomycine.Conclusion: Il est essentiel d'envisager la possibilité que des mé dicaments soient à l'origine de changements histologiques de type MF afin d'en pré venir le traitement inutile.
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