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Wang WE, Ho CC, Chang CH. Taxane-Induced Cutaneous Toxic Effects. JAMA Dermatol 2024; 160:771-772. [PMID: 38837155 DOI: 10.1001/jamadermatol.2024.1204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
This case report describes dusky red to violaceous lesions with desquamation on the wrists and dorsal surface of both hands and near the Achilles tendon that occurred after intravenous paclitaxel treatment for invasive ductal carcinoma of the breast.
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Affiliation(s)
- Wei-En Wang
- Skin Institute, Department of Dermatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Ching-Chun Ho
- Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chung-Hsing Chang
- Skin Institute, Department of Dermatology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Doctoral Degree Program in Translational Medicine, Tzu Chi University and Academia Sinica, College of Medicine, Tzu Chi University, Hualien, Taiwan
- Institute of Medical Sciences, College of Medicine, Tzu Chi University, Hualien, Taiwan
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2
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Kaur J, Gaurav V, Tyagi M. Paclitaxel-Induced Periarticular Thenar Erythema with Onycholysis Syndrome. Skin Appendage Disord 2024; 10:74-77. [PMID: 38313568 PMCID: PMC10836932 DOI: 10.1159/000534118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/12/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Periarticular thenar erythema with onycholysis (PATEO) syndrome is a rare subtype of hand-foot syndrome seen in patients undergoing taxane-based chemotherapy. It presents as erythematous to violaceous plaques on the dorsum of hands, feet, and around the Achilles tendon along with nail changes, particularly onycholysis. Case Presentation A 39-year-old female on paclitaxel chemotherapy for stage IIIA (T3N2aM0) invasive ductal breast carcinoma, presented with mildly tender erythematous to violaceous plaques involving the dorsa of bilateral hands and feet, in the periarticular areas of the Achilles tendon, with facial involvement. All fingernails showed shortening, orange-red chromonychia, Beau's lines, onychoschizia, and subungual debris. The toenail involvement was relatively less severe, with distal onycholysis being the predominant finding. The patient showed significant improvement in cutaneous lesions with topical steroid therapy and was advised cold water immersion during subsequent chemotherapy infusions. Discussion A shorter interval between cycles and a higher cumulative number of cycles correlate with severity of dermatitis and nail involvement. Rarely, periocular and facial involvement can occur concurrently with PATEO syndrome. This case is being reported to increase awareness about this entity facilitating early diagnosis and treatment.
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Affiliation(s)
- Japnoor Kaur
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Gaurav
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Mehul Tyagi
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Montero P, Pérez-Leal M, Pérez-Fidalgo JA, Sanz C, Estornut C, Roger I, Milara J, Cervantes A, Cortijo J. Paclitaxel Induces Epidermal Molecular Changes and Produces Subclinical Alterations in the Skin of Gynecological Cancer Patients. Cancers (Basel) 2022; 14:cancers14051146. [PMID: 35267454 PMCID: PMC8909563 DOI: 10.3390/cancers14051146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Skin toxicity is one of paclitaxel’s adverse effects. However, its real impact on the skin could be underestimated as these alterations can also appear asymptomatic. We have observed that paclitaxel modifies gene and protein expression of skin markers in a 3D epidermis model, and impairs physical, physiological, and biomechanical properties of the skin in gynecologic cancer patients. These subclinical alterations might be avoided by using prophylactic measures during treatment to prevent possible future adverse reactions. Abstract Background: Paclitaxel is a microtubule-stabilizing chemotherapeutic agent. Despite its widespread use, it damages healthy tissues such as skin. The goal of this study was to prove that the real impact of paclitaxel-induced skin toxicity could be underestimated because the adverse events might appear asymptomatic. Methods: Gynecological cancer patients were recruited. Skin parameters measurements were taken after three and six paclitaxel cycles. Measurements were conducted using specific probes which measure hydration, transepidermal water loss (TEWL), sebum, elasticity and firmness, erythema, roughness, smoothness, skin thickness, and desquamation levels. Further, a 3D epidermis model was incubated with paclitaxel to analyze gene and protein expression of aquaporin 3, collagen type 1, elastin, and fibronectin. Results: Paclitaxel induced alterations in the skin parameters with no visible clinical manifestations. Gynecological cancer patients under paclitaxel treatment had a decrease in hydration, TEWL, sebum, elasticity, and thickness of the skin, while erythema, roughness, and desquamation were increased. The molecular markers, related to hydration and the support of the skin layers, and analyzed in the 3D epidermis model, were decreased. Conclusions: Results suggest that paclitaxel modifies gene and protein expression of skin-related molecular markers, and impairs different physical, physiological, and biomechanical properties of the skin of cancer patients at a subclinical level.
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Affiliation(s)
- Paula Montero
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
- Correspondence: ; Tel.: +34-963864631
| | - Martín Pérez-Leal
- Faculty of Health Sciences, Universidad Europea de Valencia, 46010 Valencia, Spain;
| | - Jose Alejandro Pérez-Fidalgo
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain;
- Biomedical Research Networking Centre on Cancer (CIBERONC), Health Institute Carlos III, 28029 Madrid, Spain
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain;
| | - Celia Sanz
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
- Health Sciences, Pre-Departmental Section of Medicine, Jaume I University of Castellón de la Plana, 12071 Castellón, Spain
| | - Cristina Estornut
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
| | - Inés Roger
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Health Institute Carlos III, 28029 Madrid, Spain
| | - Javier Milara
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Health Institute Carlos III, 28029 Madrid, Spain
- Pharmacy Unit, University General Hospital Consortium, 46014 Valencia, Spain
| | | | - Julio Cortijo
- Department of Pharmacology, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain; (C.S.); (C.E.); (I.R.); (J.M.); (J.C.)
- Biomedical Research Networking Centre on Respiratory Diseases (CIBERES), Health Institute Carlos III, 28029 Madrid, Spain
- Research and Teaching Unit, University General Hospital Consortium, 46014 Valencia, Spain
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4
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Zelman B, Lee K, Reserva J, Speiser J. A paclitaxel-induced variant of hand-foot syndrome affecting dorsal surfaces. J Cutan Pathol 2021; 48:1320-1323. [PMID: 33938036 DOI: 10.1111/cup.14040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Brandon Zelman
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois, USA
| | - Kristin Lee
- Department of Dermatology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Jeave Reserva
- Department of Dermatology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Jodi Speiser
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois, USA
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Marks DH, Qureshi A, Friedman A. Evaluation of Prevention Interventions for Taxane-Induced Dermatologic Adverse Events. JAMA Dermatol 2018; 154:1465-1472. [DOI: 10.1001/jamadermatol.2018.3465] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Dustin H. Marks
- The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Azam Qureshi
- Department of Dermatology, The George Washington University Medical Faculty Associates, Washington, DC
| | - Adam Friedman
- The George Washington University School of Medicine and Health Sciences, Washington, DC
- Department of Dermatology, The George Washington University Medical Faculty Associates, Washington, DC
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Rzepecki AK, Franco L, McLellan BN. PATEO syndrome: periarticular thenar erythema with onycholysis. Acta Oncol 2018; 57:991-992. [PMID: 29283012 DOI: 10.1080/0284186x.2017.1420912] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Alexandra K. Rzepecki
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Loren Franco
- Division of Dermatology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Beth N. McLellan
- Division of Dermatology, Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA
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