Release of doxorubicin in sweat: first step to induce the palmar-plantar erythrodysesthesia syndrome?

Jacobi, U.; Waibler, E.; Schulze, P; Sehouli, Jalid; Oskay-Özcelik, G.; Schmook, Tobias; Sterry, Wolfram; Lademann, Juergen

doi:10.1093/annonc/mdi204

Cited by 106 publications

(75 citation statements)

References 4 publications

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“…An elevated PLD concentration found in the skin of the palms and plantae supports the hypothesis that the chemotherapeutic agent is excreted in the sweat. Jacobi et al (14) reported the appearance of PPE only in patients with hyperhidrosis of these regions. Another hypothesis is that PPE develops due to an excessive concentration of toxic doxorubicin within the skin and its reaction with metal ions (particularly copper ions) (15).…”

Section: Discussionmentioning

confidence: 99%

Skin toxicity in a patient with ovarian cancer treated with pegylated liposomal doxorubicin: A case report and review of the literature

et al. 2016

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Abstract. Pegylated liposomal doxorubicin (PLD) is a form of doxorubicin enclosed in pegylated liposomes. In contrast to conventional doxorubicin, PLD is characterized by a lower incidence of cardiotoxicity and myelosuppression. However, it induces specific mucocutaneous side effects, particularly palmar-plantar erythrodysesthesia (PPE). Other dermal manifestations, such as intertrigo-like dermatitis, diffuse follicular rash, melanotic macules, maculopapular rash or recall phenomenon are less common. Mechanisms that lead to skin toxicity remain unclear, however, certain reports indicate that drug excretion in sweat, host-vs.-altered-host reactions and local mechanical microtrauma play an important role in the development of cutaneous disorders. Effective preventive and curative management has not yet been established. The current study reports a case of a 55-year-old patient with advanced ovarian cancer who developed an uncommon diffuse maculopapular rash and severe PPE during treatment with PLD. Complete regression of the skin disorder was observed after 4 weeks. At present, palliative chemotherapy provides the opportunity to prolong life and alleviate disease symptoms, nonetheless it produces a number of adverse effects. Dermal complications may affect patient quality of life and cause therapy interruption. In the light of widespread use of PLD, skin toxicity associated with this drug creates a major problem.

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Section: Discussionmentioning

confidence: 99%

Skin toxicity in a patient with ovarian cancer treated with pegylated liposomal doxorubicin: A case report and review of the literature

et al. 2016

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“…The doxorubicin liposomes are carried to skin surface by the normal sweat function, presumably favoured by the hydrophilic coating. From the skin surface, the sweat containing the drug may get through into the stratum corneum and also it functions as a source for the entry of doxorubicin into deeper skin layers and reacts with epidermal cells [17]. The exact mechanism of docetaxel, gemcitabine induced PPE is not clearly known [18,19].…”

Section: Discussionmentioning

confidence: 99%

Anticancer Drug Induced Palmar Plantar Erythrodysesthesia

Palaniappan

Srinivasamurthy

Dubashi

et al. 2014

JCDR

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“…In fact, palmar-plantar erythrodysesthesias may be related to the release of doxorubicin from liposomes in eccrine glands of the hands and feet, as documented by the appearance of doxorubicin fluorescence in sweat shortly after infusion of the drug. PLD has been identified in excretory ducts of eccrine sweat glands; a higher risk for palmarplantar erythrodysesthesia has been identified in patients with hyperhydrosis of hands [21].…”

Section: Discussionmentioning

confidence: 99%

Squamous Cell Carcinoma of the Oral Cavity in Nonsmoking Women: A New and Unusual Complication of Chemotherapy for Recurrent Ovarian Cancer?

Cannon¹,

Lai²,

Hirsch³

et al. 2012

The Oncologist

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After completing this course, the reader will be able to:1. Compare the risk of secondary cancer versus benefits of maintenance therapy for women with ovarian cancer who have a complete response to pegylated liposomal doxorubicin.2. Explain the need to perform regular and frequent oral examinations in women with ovarian cancer who received treatment with pegylated liposomal doxorubicin.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTPurpose. To describe occurrences of oral squamous cell carcinoma (SCC) in patients who had received long-term pegylated liposomal doxorubicin (PLD) for ovarian cancer. Patients and Methods. In our cohort of patients on maintenance PLD for ovarian and related mullerian epithelial malignancies, we encountered two patients with invasive SCC of the oral cavity (one of them multifocal) and one with high-grade squamous dysplasia. Review of patients at our institution receiving PLD for recurrent ovarian cancer identified three additional patients. The duration of treatment, cumulative PLD dose, human papillomavirus (HPV) positivity, BRCA status, stage at diagnosis, outcome, and other characteristics are reviewed.Results. All five cases were nonsmokers with no known risk factors for HPV and four were negative for p16 expression. Four of the patients had known BRCA mutations whereas one tested negative. Cumulative doses of PLD were >1,600 mg/m 2 given over 30 -132 months. Three had SCCs staged as T1N0 oral tongue, alveolar ridge (gingival), and multifocal oral mucosa; one had a T2N0 oral tongue; and one had dysplasia. After excision, two were given radiation but recurred shortly thereafter; the others remain well and have had no further exposure to cytotoxic drugs, including PLD. Conclusion. Awareness of this possible long-term complication during PLD treatment should enhance the likelihood of early detection of oral lesions in these patients. Decisions to continue maintenance PLD after complete re-

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Release of doxorubicin in sweat: first step to induce the palmar-plantar erythrodysesthesia syndrome?

Cited by 106 publications

References 4 publications

Skin toxicity in a patient with ovarian cancer treated with pegylated liposomal doxorubicin: A case report and review of the literature

Skin toxicity in a patient with ovarian cancer treated with pegylated liposomal doxorubicin: A case report and review of the literature

Anticancer Drug Induced Palmar Plantar Erythrodysesthesia

Squamous Cell Carcinoma of the Oral Cavity in Nonsmoking Women: A New and Unusual Complication of Chemotherapy for Recurrent Ovarian Cancer?

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