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Tempark T, John S, Rerknimitr P, Satapornpong P, Sukasem C. Drug-Induced Severe Cutaneous Adverse Reactions: Insights Into Clinical Presentation, Immunopathogenesis, Diagnostic Methods, Treatment, and Pharmacogenomics. Front Pharmacol 2022; 13:832048. [PMID: 35517811 PMCID: PMC9065683 DOI: 10.3389/fphar.2022.832048] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/01/2022] [Indexed: 12/19/2022] Open
Abstract
SCARs are rare and life-threatening hypersensitivity reactions. In general, the increased duration of hospital stays and the associated cost burden are common issues, and in the worst-case scenario, they can result in mortality. SCARs are delayed T cell-mediated hypersensitivity reactions. Recovery can take from 2 weeks to many months after dechallenging the culprit drugs. Genetic polymorphism of the HLA genes may change the selection and presentation of antigens, allowing toxic drug metabolites to initiate immunological reactions. However, each SCARs has a different onset latency period, clinical features, or morphological pattern. This explains that, other than HLA mutations, other immuno-pathogenesis may be involved in drug-induced severe cutaneous reactions. This review will discuss the clinical morphology of various SCARs, various immune pathogenesis models, diagnostic criteria, treatments, the association of various drug-induced reactions and susceptible alleles in different populations, and the successful implementation of pharmacogenomics in Thailand for the prevention of SCARs.
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Affiliation(s)
- Therdpong Tempark
- Division of Dermatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,The Pediatrics-Thai Severe Cutaneous Adverse Drug Reaction (Ped-Thai-SCAR) Research Group, Bangkok, Thailand
| | - Shobana John
- Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Bangkok, Thailand
| | - Pawinee Rerknimitr
- The Thai Severe Cutaneous Adverse Drug Reaction (Thai-SCAR) Research Group, Bangkok, Thailand.,Division of Dermatology, Department of Medicine, Faculty of Medicine, Skin, and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
| | - Patompong Satapornpong
- Division of General Pharmacy Practice, Department of Pharmaceutical Care, College of Pharmacy, Rangsit University, Pathum Thani, Thailand.,Excellence Pharmacogenomics and Precision Medicine Centre, College of Pharmacy, Rangsit University, Pathum Thani, Thailand
| | - Chonlaphat Sukasem
- The Pediatrics-Thai Severe Cutaneous Adverse Drug Reaction (Ped-Thai-SCAR) Research Group, Bangkok, Thailand.,Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC), Ramathibodi Hospital, Bangkok, Thailand.,The Thai Severe Cutaneous Adverse Drug Reaction (Thai-SCAR) Research Group, Bangkok, Thailand.,Pharmacogenomics and Precision Medicine, The Preventive Genomics & Family Check-up Services Center, Bumrungrad International Hospital, Bangkok, Thailand.,MRC Centre for Drug Safety Science, Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
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Vila-Payeras A, Iglesias-González M, Terrasa-Sagristá F, Parera-Amer E. Cutaneous ulcer with thrombogenic vasculopathy in a patient receiving bevacizumab. Indian J Dermatol Venereol Leprol 2021; 87:268-270. [PMID: 33769753 DOI: 10.25259/ijdvl_398_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 09/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Aina Vila-Payeras
- Department of Dermatology, Son Llàtzer Hospital, Palma de Mallorca, Spain
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Cohen PR, Prieto VG, Kurzrock R. Tumor Lysis Syndrome: Introduction of a Cutaneous Variant and a New Classification System. Cureus 2021; 13:e13816. [PMID: 33859885 PMCID: PMC8038896 DOI: 10.7759/cureus.13816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Tumor lysis syndrome, an oncological emergency, is characterized by laboratory parameters such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, as well as renal injury with an elevated creatinine. Tumor lysis syndrome is seen in patients with aggressive malignancies and high tumor burden. More frequently, it occurs in individuals with hematologic malignancies such as high-grade lymphomas (such as Burkitt lymphoma) and leukemia (such as acute lymphocytic leukemia). It also, albeit less commonly, can be seen in patients with widespread solid tumors that are rapidly proliferating and are markedly sensitivity to antineoplastic therapy. Tumor lysis syndrome is usually preceded by cancer-directed therapy; however, the syndrome can present spontaneously prior to the individual receiving malignancy-directed treatment. We reported a man with metastatic salivary duct carcinoma who had cutaneous metastases that presented as carcinoma hemorrhagiectoides. Microscopic examination demonstrated that the metastatic tumor cells had infiltrated and replaced the entire dermis. After the patient received his first dose of antineoplastic therapy, he had an excellent response and the cutaneous metastases developed into ulcers; we hypothesize that most of the dermis, which had been replaced by tumor cells, disappeared as a result of the therapeutic response, and the overlying epidermis became necrotic and shed, leaving an ulcer. His dramatic response to treatment prompted us to propose a new classification of tumor lysis syndrome, which should include the systemic form of the condition as well as the new variant: cutaneous tumor lysis syndrome. We anticipate that, with improvement in targeted therapies, there may be an increase in therapy-associated cutaneous tumor lysis syndrome.
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Affiliation(s)
- Philip R Cohen
- Dermatology, San Diego Family Dermatology, National City, USA
| | | | - Razelle Kurzrock
- Center for Personalized Cancer Therapy, University of California San Diego Moores Cancer Center, La Jolla, USA
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Suehara Y, Osawa H, Kubota D, Kato S, Akaike K, Tanabe Y, Saito T, Kaneko K. Large Skin Ulcer Due to a Subcutaneous Orthopaedic Implant After Bevacizumab Therapy: A Case Report. JBJS Case Connect 2016; 6:e70. [PMID: 29252647 DOI: 10.2106/jbjs.cc.15.00281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE Bevacizumab is a vascular endothelial growth factor (VEGF) inhibitor that is involved in the inhibition of vasculogenesis and angiogenesis. We report the case of a patient who developed a severe skin ulcer at the site of the surgical incision 5 years after clavicular fracture fixation with a titanium plate. This ulcer represents an adverse event of bevacizumab therapy for sigmoid colon cancer. CONCLUSION Bevacizumab therapy is widely used, particularly for the treatment of metastatic colon cancer and other solid tumors, although it is associated with several adverse events, including delayed wound-healing and skin ulcers. However, to our knowledge, orthopaedic-related adverse events have not previously been reported.
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Affiliation(s)
- Yoshiyuki Suehara
- Departments of Orthopedic Surgery (Y.S., H.O., D.K., K.A., Y.T., and K.K.), Medical Oncology (S.K.), and Human Pathology (K.A. and T.S.), Juntendo University School of Medicine, Tokyo, Japan
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Pike S, Zhang P, Wei Z, Wu N, Klinger A, Chang S, Jones R, Carpenter J, Brown SA, DiMuzio P, Tulenko T, Liu Y. In vitro effects of tamoxifen on adipose-derived stem cells. Wound Repair Regen 2015; 23:728-36. [PMID: 26043659 DOI: 10.1111/wrr.12322] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 05/29/2015] [Indexed: 01/16/2023]
Abstract
In breast reconstructive procedures, adipose-derived stem cells (ASCs) that are present in clinical fat grafting isolates are considered to play the main role in improving wound healing. In patients following chemotherapy for breast cancer, poor soft tissue wound healing is a major problem. However, it is unclear if tamoxifen (TAM) as the most widely used hormonal therapeutic agent for breast cancer treatment, affects the ASCs and ultimately wound healing. This study evaluated whether TAM exposure to in vitro human ASCs modulate cellular functions. Human ASCs were isolated and treated with TAM at various concentrations. The effects of TAM on cell cycle, cell viability and proliferation rates of ASCs were examined by growth curves, MTT assay and BrdU incorporation, respectively. Annexin V and JC-1 Mitochondrial Membrane Potential assays were used to analyze ASC apoptosis rates. ASCs were cultured in derivative-specific differentiation media with or without TAM (5 uM) for 3 weeks. Adipogenic and osteogenic differentiation levels were measured by quantitative RT-PCR and histological staining. TAM has cytotoxic effects on human ASCs through apoptosis and inhibition of proliferation in dose- and time-dependent manners. TAM treatment significantly down-regulates the capacity of ASCs for adipogenic and osteogenic differentiation (p<0.05 vs. control), and inhibit the ability of the ASCs to subsequently formed cords in Matrigel. This study is the first findings to our knowledge that demonstrated that TAM inhibited ASC proliferation and multi-lineage ASC differentiation rates. These results may provide insight into the role of TAM with associated poor soft tissue wound healing and decreased fat graft survival in cancer patients receiving TAM.
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Affiliation(s)
- Steven Pike
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Ping Zhang
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Zhengyu Wei
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Nan Wu
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Aaron Klinger
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Shaohua Chang
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Robert Jones
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Jeffrey Carpenter
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Spencer A Brown
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Paul DiMuzio
- Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Thomas Tulenko
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
| | - Yuan Liu
- Department of Surgery, Cooper University Hospital, Camden, New Jersey
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