Generalized eruptive lentiginosis induced by chemotherapy

Abstract

Summary Lentigines are characterized by brown macules developing due to increased proliferation of melanocytes in the dermoepidermal junction. Many drugs, including immunosuppressants and immunomodulators, have been shown to cause generalized lentiginosis. We describe a case of lentiginosis induced by cancer chemotherapy, an extremely rare occurrence.

Rare case of Netherton syndrome with generalized lentigines

“…The mechanisms of generalized lentigines remain uncertain. Congenital lentigines usually transmit in an autosomal dominant manner and are familial, 3 whereas our case had no familial history and related gene mutations. Acquired lentigines associate with factors like UV overexposure, inflammation and chemotherapy.…”

“…Acquired lentigines associate with factors like UV overexposure, inflammation and chemotherapy. [2][3][4] We speculated that in our case lentigines could have resulted from epidermal re-epithelization and inflammation associated with NS, although further studies are needed to confirm this association and mechanisms.…”

“Eruptive Lentiginosis” in a Patient With Vitiligo and Inflammatory Bowel Disease Treated With Azathioprine

“…The pathophysiology of this condition is unknown, although has been hypothesized that a reduction of the role of immune surveillance and drug-induced proliferation of melanocytes could have a causal role in predisposed patients. 8 "Eruptive lentiginosis" has been also reported in association using biological agents such as etanercept within the psoriatic plaques. 9 This finding should be distinguished from the appearance of multiple nevi secondarily to immunosuppression.…”

The Itch that… freckles? Development of lentigines in areas of resolved chronic atopic dermatitis

“…Although there is no known mechanism for an effect of TCIs on melanocytes, it has been hypothesized that mild immunosuppression may contribute, similar to the association of chemotherapy or immunosuppression and impaired immune surveillance of the skin with subsequent development of lentigines . Proposed mechanisms in the psoriasis literature involve TNF‐α‐ and IL‐17‐induced dense clusters of chronically suppressed melanocytes in psoriatic plaques which, following treatment, experience a brisk loss of cytokine inhibition leading to pigmentary hyperproduction .…”

“…may contribute, similar to the association of chemotherapy or immunosuppression and impaired immune surveillance of the skin with F I G U R E 1 A, Patient 1's left wrist at age 4 demonstrating improving dermatitis without evidence of lentigines. B, Patient 1's hands at age 7 showing multiple tan macules at the sites of prior atopic dermatitis lentigines 4. Proposed mechanisms in the psoriasis literature involve TNF-α-and IL-17-induced dense clusters of chronically suppressed melanocytes in psoriatic plaques which, following treatment, experience a brisk loss of cytokine inhibition leading to pigmentary hyperproduction 3.…”