Development of Aggressive Squamous Cell Carcinoma With Perineural Invasion During Ruxolitinib Treatment

Dunaway, Spencer; Yu, Yan; Neltner, Scott

doi:10.1097/dss.0000000000001626

Cited by 17 publications

(7 citation statements)

References 4 publications

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“…1 Reported adverse events are varied, likely because of the ubiquitous nature of JAK signaling in normal physiology. 1,4,5 This case of LyP in a patient taking tofacitinib highlights the need for further investigation of these agents' relationship with lymphoproliferative disorders and immune-mediated adverse events.…”

Section: Discussionmentioning

confidence: 96%

“…2 Predisposition to infection, immunemediated adverse events, and development of aggressive keratinocyte carcinomas are well-documented side effects of these medications, although the etiologic mechanisms remain unclear. [3][4][5] Because these medications see increased usage, reports of less common reactions are appearing in the literature. We report the development of lymphomatoid papulosis (LyP) with ophthalmologic involvement in a patient receiving tofacitinib for refractory erythema elevatum diutinum (EED).…”

Section: Introductionmentioning

confidence: 99%

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A Case of Tofacitinib-Induced Lymphomatoid Papulosis With Ocular Involvement

Knapp

Steele

Mengden-Koon

et al. 2022

The American Journal of Dermatopathology

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Janus kinase (JAK) inhibitors are being prescribed with increasing regularity in dermatology. We report on a patient who initiated treatment with tofacitinib for refractory erythema elevatum diutinum and subsequently developed a novel cutaneous outbreak characterized by firm violaceous papules on the trunk and extremities along with conjunctival injection and periorbital inflammation. Biopsy of affected tissue from both the cutaneous and ophthalmologic sources demonstrated increased numbers of CD30 + large atypical cells amid a mixed inflammatory cell infiltrate, consistent with lymphomatoid papulosis. A review of the literature reveals a plausible mechanism for the induction of persistent JAK signaling in the presence of a JAK inhibitor. We discuss this mechanism in depth because it pertains to this patient and recommend continued vigilance with the use of these immunologic agents.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

A Case of Tofacitinib-Induced Lymphomatoid Papulosis With Ocular Involvement

Knapp

Steele

Mengden-Koon

et al. 2022

The American Journal of Dermatopathology

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“…The patient in the current report was also started on ruxolitinib 18 months ago, which, according to the existing literature, may additionally induce skin cancer progression. ruxolitinib alters the number and function of T-lymphocytes and NK-cells, by blocking Janus kinase 1 and 2 receptors, further promoting an imbalance in immune and inflammatory responses [9]. When Ruxolitinib treatment was initiated, the patient had received a BCC diagnosis two years prior and reported pre-existing multiple skin lesions.…”

Section: Discussionmentioning

confidence: 99%

Clinical Insights and Dermatological Recommendations for Non-Melanoma Skin Cancers (NMSCs) in Long-Term Hydroxyurea (HU) Therapy

Iliescu,

Beiu,

Slavu

et al. 2024

Cureus

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Hydroxyurea (HU), an anti-metabolite ribonucleotide reductase inhibitor, is commonly used to treat several myeloproliferative disorders, including polycythemia vera. However, patients receiving long-term treatment with HU may experience a variety of cutaneous side effects, with non-melanoma skin cancers (NMSCs) emerging as the most challenging and destructive. HU-induced carcinogenesis can be attributed to both the drug's mutagenic potential and impaired DNA repair following damage by external triggers such as ultraviolet light. We report a unique case of multiple aggressive NMSCs distributed within sun-exposed areas in an 81-year-old woman receiving chronic therapy with HU for 15 years. The case draws the clinician's attention to the increased incidence of NMSCs in this population and highlights the need for regular dermatologic monitoring. We also elaborate relevant insights and recommendations to assist healthcare providers in managing HU-related NMSCs development and progression.

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“…It recurred despite extensive surgery into the parotid gland and facial nerve. 7 The rare Merkel cell carcinoma was also reported with the long-term use of ruxolitinib. After having received ruxolitinib for 7 years, 1 patient developed this highly aggressive tumor on her elbow, with lymphovascular invasion and nodal involvement.…”

Section: Introductionmentioning

confidence: 99%

“…Several case reports have demonstrated the association of aggressive nonmelanoma skin cancers with the Janus kinase inhibitor ruxolitinib. 6 , 7 , 8 In 1 report, a patient with a remote history of 1 BCC developed numerous SCCs after initiation of ruxolitinib, including an aggressive SCC located on the lower lip vermilion border, which was poorly differentiated, with extension into the orbicularis oris muscle and extensive perineural invasion. 6 After 1 year of treatment, another patient received a diagnosis of a highly aggressive SCC on the cheek, with extension into the parotid gland and extensive perineural invasion.…”

Section: Introductionmentioning

confidence: 99%