Lichenoid Mucosal Reaction to Rituximab

Kuten‐Shorrer, Michal; Hochberg, Ephraim P.; Woo, Sook‐Bin

doi:10.1634/theoncologist.2014-0169

Cited by 26 publications

(21 citation statements)

References 7 publications

(10 reference statements)

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“…In 2012, a case study conducted by Bakkour and Coulson reported a widespread cutaneous lichenoid eruption related to the administration of obinutuzumab, a new anti-CD20 monoclonal antibody, in a patient with relapsed follicular lymphoma previously treated with rituximab [5]. Two years later, Kuten-Shorrer et al reported the first case of OLDR in a patient treated with rituximab for a stage IIIA follicular lymphoma [17].…”

Section: Discussionmentioning

confidence: 99%

Oral Lichenoid Reaction: An Uncommon Side Effect of Rituximab

Giudice

Liborio

Averta

et al. 2019

Case Reports in Dentistry

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Oral lichenoid reactions (OLR) can be caused by systemic drug exposure. To the best of our knowledge, this is the second report describing a case of OLR induced by rituximab administration in a patient with a diagnosis of non-Hodgkin B-cell lymphoma. After 5 doses of rituximab, a typical pattern of OLP was identified with bilateral and symmetrical lesions on the buccal mucosa and on the right lingual margin. This temporal relationship suggested a probable association between oral lesions and drug therapy. The clinical diagnosis of a rituximab-induced OLR was confirmed by an incisional biopsy reporting a histopathological result of lichenoid mucositis consistent with oral lichen planus. Because of the increasing use of rituximab, it is necessary to know and recognize this uncommon side effect.

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Section: Discussionmentioning

confidence: 99%

Oral Lichenoid Reaction: An Uncommon Side Effect of Rituximab

Giudice

Liborio

Averta

et al. 2019

Case Reports in Dentistry

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“…Lichenoid drug eruptions are relatively common and occur secondary to numerous medications including β-adrenergic blockers, antimalarials, penicillamine, quinine, gold-containing substances, antihypertensive medications, proton pump inhibitors, intravenous immunoglobulins (IVIGs), monoclonal antibodies against tumor necrosis factor-alpha (TNF-α; eg, etanercept, adalimumab, infliximab), and anti-CD20 (rituximab). 28 -31 Numerous case reports of lichenoid eruptions secondary to ICIs have been described. Lichenoid eruptions occur more frequently with anti-PD-1/anti-PD-L1 agents rather than with CTLA-4 inhibitors.…”

Section: Lichenoid Reactionsmentioning

confidence: 99%

Cutaneous Immune-Related Adverse Events (irAEs) to Immune Checkpoint Inhibitors: A Dermatology Perspective on Management

et al. 2020

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Immune checkpoint inhibitors have proven to be efficacious for a broad spectrum of solid organ malignancies. These monoclonal antibodies lead to cytotoxic T-cell activation and subsequent elimination of cancer cells. However, they can also lead to immune intolerance and immune-related adverse event (irAEs) that are new and specific to these therapies. Cutaneous irAEs are the most common, arising in up to 34% of patients on PD-1 inhibitors and 43% to 45% on CTLA-4 inhibitors. The most common skin manifestations include maculopapular eruption, pruritus, and vitiligo-like lesions. A grading system has been proposed, which guides management of cutaneous manifestations based on the percent body surface area (BSA) involved. Cutaneous irAEs may prompt clinicians to reduce drug doses, add systemic steroids to the regiment, and/or discontinue lifesaving immunotherapy. Thus, the goal is for early identification and concurrent management to minimize treatment interruptions. We emphasize here that the severity of the reaction should not be graded based on BSA involvement alone, but rather on the nature of the primary cutaneous pathology. For instance, maculopapular eruptions rarely affect <30% BSA and can often be managed conservatively with skin-directed therapies, while Stevens-Johnson syndrome (SJS) affecting even 5% BSA should be managed aggressively and the immunotherapy should be discontinued at once. There is limited literature available on the management of the cutaneous irAEs and most studies present anecdotal evidence. We review the management strategies and provide recommendations for psoriatic, immunobullous, maculopapular, lichenoid, acantholytic eruptions, vitiligo, alopecias, vasculitides, SJS/toxic epidermal necrolysis, and other related skin toxicities.

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“…LR can disappear, either immediately after the agent's action is completed, or can persist. [55] In addition, histologic examination reveals eosinophilic infiltration, prominent parakeratosis with acanthosis, and a vascular inflammation around the deep plexuses. These histologic features are absent in OLP.…”

Section: Lichenoid Reactionsmentioning

confidence: 99%

“…[57] It is responsible for lichenoid lesions in the oral mucosa, skin, or nails. [55,56,58] Suggestions have been expressed concerning the pathogenesis of LRs and LRs relationship with chemotherapy. Imatinib is responsible for the altered expression of epidermal markers.…”

Section: Lichenoid Reactionsmentioning

confidence: 99%

Chemotherapy: oral side effects and dental interventions. A review of the literature

Poulopoulos¹,

Papadopoulos²,

Andreadis³

2017

SDS

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Even with the evolution of chemotherapeutic procedures and agents, chemotherapy may cause certain side effects that impair the patients' quality of life. The aim of this review is to isolate and describe the oral side effects arising only from chemotherapy and focus on the dentist's contribution to their management. This paper comprises an extensive literature review of the main side effects affecting the oral health status of patients' undergoing chemotherapy procedures. In addition, it describes the dentist's contribution in the treatment of such patients before, throughout and after antineoplastic therapy. In conclusion, the oral cavity is a usual site of discomfort and pain caused by chemotherapy, making the dentist's contribution to the patient's relief imperative. Key words:Chemotherapy, oral side effects, oral mucositis, oral infections ABSTRACTArticle history:

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Lichenoid Mucosal Reaction to Rituximab

Cited by 26 publications

References 7 publications

Oral Lichenoid Reaction: An Uncommon Side Effect of Rituximab

Oral Lichenoid Reaction: An Uncommon Side Effect of Rituximab

Cutaneous Immune-Related Adverse Events (irAEs) to Immune Checkpoint Inhibitors: A Dermatology Perspective on Management

Chemotherapy: oral side effects and dental interventions. A review of the literature

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