Ribociclib-Induced Erythema Dyschromicum Perstans (Ashy Dermatosis)–Like Pigmentation in a Metastatic Breast Cancer Patient

Mariano, Maria; Donati, Pietro; Cameli, Norma; Pigliacelli, Flavia; Morrone, Andrea; Cristaudo, Antonio

doi:10.4048/jbc.2021.24.e1

Cited by 14 publications

(8 citation statements)

References 9 publications

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“…[181][182][183][184][185][186][187][188][189] There are rare reported cases (although more than with other Nibs) of blistering dermatitis (9%), including bullous pemphigoid. 190,191 Cases of discoid or subacute chronic lupus, [192][193][194][195] ashy dermatosis (erythema dyschromicum perstans), 196 leukocytoclastic vasculitis, 197 and SJS [198][199][200][201] have also been reported with CDK4/6 inhibitors. $20% to 80%-90%, making CML the first cancer to strongly respond to targeted anticancer therapy.…”

Section: Cdk4/6 Inhibitorsmentioning

confidence: 99%

Diverse landscape of dermatologic toxicities from small‐molecule inhibitor cancer therapy

et al. 2021

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Background: Advances in molecular biology and genetics have contributed to breakthrough treatments directed at specific pathways associated with the development of cancer. Small-molecule inhibitors (Nibs) aimed at a variety of cellular pathways have been efficacious; however, they are associated with significant dermatologic toxicities. Methods: We conducted a comprehensive review of dermatologic toxicities associated with Nibs categorized into the following five groups: (a) mitogen-activated protein kinase; (b) growth factor/multi-tyrosine kinase; (c) cell division/DNA repair; (d) signaling associated with myeloproliferative neoplasms; and (e) other signaling pathways. Prospective phase I, II, or III clinical trials, retrospective literature reviews, systematic reviews/meta-analyses, and case reviews/reports were included for analysis.Results: Dermatologic toxicities reviewed were associated with every class of Nibs and ranged from mild to severe or life-threatening adverse skin reactions.Inflammatory reactions manifesting as maculopapular, papulopustular/acneiform, and eczematous lesions were frequent types of dermatologic toxicities seen with Nibs.Squamous cell carcinoma with keratoacanthoma-like features was associated with a subset of Nibs. Substantial overlap in dermatologic toxicities was found between Nibs.Conclusions: Dermatologic toxicities from Nibs are diverse and may overlap between classes of Nibs. Recognition of the various types of toxicities from Nibs is critical for patient care in the era of "oncodermatology/dermatopathology."

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Section: Cdk4/6 Inhibitorsmentioning

confidence: 99%

Diverse landscape of dermatologic toxicities from small‐molecule inhibitor cancer therapy

et al. 2021

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“…25 More severe and devastating events have been reported; one case of acute bullous skin rash, 26 three cases of Stevens-Johnson syndrome (SJS), 18,27,28 one case of toxic epidermal necrolysis (TEN), 29 one case of histiocytoid Sweet syndrome, 30 and one case of erythema dyschromicum perstans (ashy dermatosis)-like pigmentation. 31 The association between cancer and vitiligo has been previously studied. The risk of melanoma and nonmelanoma skin cancers was significantly lower in a group of 10,040 Italian patients with vitiligo.…”

Section: Discussionmentioning

confidence: 99%

“… 25 More severe and devastating events have been reported; one case of acute bullous skin rash, 26 three cases of Stevens–Johnson syndrome (SJS), 18 , 27 , 28 one case of toxic epidermal necrolysis (TEN), 29 one case of histiocytoid Sweet syndrome, 30 and one case of erythema dyschromicum perstans (ashy dermatosis)-like pigmentation. 31 …”

Section: Discussionmentioning

confidence: 99%

Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature Review

Sharaf¹,

AlMasri²,

Abdel-Razeq³

et al. 2022

CCID

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Background: Cyclin-dependent kinase (CDK) 4/6 inhibitors have revolutionized the treatment landscape of hormone receptor-positive (HR + ), human epidermal growth factor receptor 2-negative (HER2 − ) metastatic breast cancer, with an impressive efficacy and safety profile. Cytopenia is the main adverse event, which is both predictable and manageable. Here, we report a case of CDK4/6 inhibitor-induced vitiligo-like lesions. Vitiligo or vitiligolike lesions are a rare adverse event; only a few cases are reported in the literature. Case Presentation: A 71-year-old female patient was diagnosed initially with early-stage right breast cancer (HR + /HER2 − ) and was treated with breast-conserving surgery followed by chemotherapy, radiotherapy, and hormonal therapy. A few years later, she developed metastatic disease to the hilar lymph nodes, and to multiple skeletal sites, including the left scapula, left shoulder, left iliac bone, and dorsal vertebrae, for which she was treated with ribociclib and letrozole. While on treatment, she developed hypopigmented lesions involving both hands, feet, and face, which were described as vitiligo-like lesions. Conclusion: CDK4/6 inhibitor-induced vitiligo is a rare and unpredictable adverse event. This case report highlights the rarity of this adverse event, the dilemma related to the optimal treatment, and decisions related to continuation, holding, or switching CDK4/6 inhibitors.

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“…Common cutaneous adverse events include alopecia, pruritus, maculopapular rash and vitiligo-like lesions 2. Steven-Johnsons syndrome and erythema-dyschromicum-perstans-like-pigmentation have also been reported in patients on ribociclib 3 4…”

Section: Introductionmentioning

confidence: 99%

Ribociclib-induced extensive vitiligo-like lesions: possible pathomechanisms with clinical, dermoscopic and histological correlation

et al. 2022

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Cyclin dependent kinase (CDK) 4/6 inhibitors are targeted agents which act on cyclin-D and these combined with hormonal therapy have been approved for the treatment of locally advanced or metastatic breast cancer. CDK 4/6 inhibitors have been found to have a tolerable adverse event profile; however, they have been associated with various dermatological adverse events. We report a case of ribociclib-induced vitiligo and discuss the clinical, dermoscopic and histological features with a review of the various possible pathomechanisms involved.

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Ribociclib-Induced Erythema Dyschromicum Perstans (Ashy Dermatosis)–Like Pigmentation in a Metastatic Breast Cancer Patient

Cited by 14 publications

References 9 publications

Diverse landscape of dermatologic toxicities from small‐molecule inhibitor cancer therapy

Diverse landscape of dermatologic toxicities from small‐molecule inhibitor cancer therapy

Vitiligo-Like Lesions in a Patient with Metastatic Breast Cancer Treated with Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor: A Case Report and Literature Review

Ribociclib-induced extensive vitiligo-like lesions: possible pathomechanisms with clinical, dermoscopic and histological correlation

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