RT Journal Article
SR Electronic
T1 Docetaxel (taxotere) induced subacute cutaneous lupus erythematosus: report of 4 cases.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 818
OP 820
VO 31
IS 4
A1 Michael Chen
A1 A Neil Crowson
A1 Melinda Woofter
A1 Mary Beth Luca
A1 Cynthia M Magro
YR 2004
UL http://www.jrheum.org/content/31/4/818.abstract
AB OBJECTIVE: We describe 4 patients who developed subacute cutaneous lupus erythematosus (SCLE)-like photodistributed eruptions after ingestion of docetaxel (Taxotere). The development of SCLE-like cutaneous eruptions has been associated with the intake of drugs including thiazide diuretics, calcium channel blockers, angiotensin converting-enzyme inhibitors, phenytoin, etanercept, antihistaminics, interferons, statins, and terbinafine. Docetaxel, a chemotherapeutic drug used in breast cancer therapy, has not to our knowledge been reported to cause SCLE. METHODS: Skin biopsies were obtained from 4 patients with photodistributed rashes while taking docetaxel. RESULTS: In all patients, skin biopsies were remarkable for an atrophying interface dermatitis associated with mucin deposition. Immunofluorescent testing revealed the characteristic pattern of SCLE, namely, granular epidermal keratinocyte deposition of IgG and C5b-9. The eruptions resolved following cessation of the drug. CONCLUSION: Pathogenetically, docetaxel may evoke a lupus-like eruption through its proapoptotic effects on replicating cells, which could in turn provoke the release of nucleosomes postulated to be target antigens in LE. It seems reasonable to postulate that the rapidly replicating keratinocyte, when subjected to the cytotoxic effects of docetaxel, would also manifest nucleosome release followed by a local autoimmune reaction in a genetically predisposed host.