Cutaneous Reactions to Novel Therapeutics

Abstract

In the last 2 decades the introduction new biologic agents such as tumor necrosis factor alpha inhibitors has resulted in potent disease modifying effects in a variety of immune-mediated diseases. In addition, there were major advancements in cancer treatment due to chemotherapeutic agents including granulocyte macrophage-colony-stimulating factor, interferon, epidermal growth factor receptor inhibitors, and kinase inhibitors for the treatment of hematologic malignancies as well as solid tumors. However, a variety of toxicities including cutaneous reactions is seen in association with these agents. Awareness of commonly associated skin toxicities and recognition of corresponding histologic features is of importance.

Dermatological adverse effects in a cancer patient treated with an EGFR inhibitor. Case report and literature review

“…Histopathological examination of specimens of papulopustular lesions demonstrated some minor inflammatory infiltrations around dilated orifices of hair follicles filled with corneous masses. Disruption of hair follicles was also observed, with an acute, mostly neutrophilic inflammation around, that in time could transform into chronic granulomatous form, close to histopathological presentation of papulopustular eruptions observed in acne [12,13]. Inflammatory infiltrations consisted mostly of neutrophils or components of chronic granulomatous infiltrations: lymphocytes, histiocytes and giant cells [14].…”

“…W badaniu histopatologicznym wycinków pobranych ze zmian grudkowo-krostkowych obserwowano niewielkie powierzchowne nacieki zapalne dookoła poszerzonych i wypełnionych masami rogowymi ujść mieszków włosowych. Dochodziło także do przerwania mieszka włosowego z ostrym, głównie neutrofilowym zapaleniem dookoła, które mogło z czasem przybierać formę przewlekłą ziarniniakową, co jest bliskie obrazowi histopatologicznemu zapalnych wykwitów grudkowo-krostkowych w trądziku [12,13]. W składzie nacieków zapalnych stwierdzono przede wszystkim neutrofile lub składowe przewlekłych nacieków ziarniniakowych: limfocyty, histiocyty i komórki olbrzymie [14].…”

Cytokines Induced Skin Adverse Reactions

“…Interferon (IFN), a family of secretory glycoproteins, is an immune modulating agent that is used in the treatment of viral infections, tumors, and inflammatory conditions including multiple sclerosis [1]. The three main types of IFNs are classified according to their nucleic acid sequence: alpha, beta, and gamma.…”