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[(papules, some with annular configuration, of the arms, legs, and )17.8 (V)-305.5 (of the)]TJ
0.036 Tw 0 -1.25 TD
[(chest. Serologic studies were positive for SSA)-231.2 (and SSB antibodies as well)]TJ
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[(as positive antinuclear antibody \(ANA; 1:160, speckled pattern\). )54.8 (A)-236.2 (biopsy)]TJ
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(revealed an atrophying interface dermatitis characterized by epithelial)Tj
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(attenuation with lymphocyte tagging along the dermal-epidermal junction)Tj
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(accompanied by basilar vacuolar change with keratinocyte necrosis. In)Tj
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(addition there was splaying of the dermis by abundant mesenchymal)Tj
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(mucin. Direct immunofluorescent testing showed prominent granular depo-)Tj
0.0596 Tw T*
[(sition of IgG and Cb-9 within epidermal keratinocytes. )17.7 (W)39.8 (ithdrawal of the)]TJ
0.30341 Tw T*
(docetaxel and application of triamcinolone acetonide 0.1% to lesions)Tj
0.02499 Tw T*
(resulted in resolution of lesions.)Tj
/T1_1 1 Tf
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(Case 4.)Tj
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[(A)-250.9 (69-year)19.7 (-old woman was diagnosed with adenocarcinoma of the)]TJ
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(lung in May 2003. She began chemotherapy consisting of carboplatin and)Tj
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[(paclitaxel \(T)69.7 (axol\) in July 2003. She tolerated the initial 4 treatments.)]TJ
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[(However)39.7 (, 7 days after receiving her fifth treatment she developed an)]TJ
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[(erythematous, mildly scaling eruption involving the )17.8 (V)-342.1 (of the chest, right)]TJ
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(arm, and upper back. Histopathologic examination revealed an atrophying)Tj
0.3535 Tw T*
(interface dermatitis with concomitant mesenchymal mucin deposition)Tj
0.0594 Tw T*
(compatible with SCLE. Her clinical lesions resolved within 4 weeks after\
)Tj
0.15469 Tw T*
(discontinuation of paclitaxel. Direct immunofluorescent studies revealed\
)Tj
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(weak staining of epidermal keratinocytes for C5b-9, corroborating the di\
ag-)Tj
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(nosis of partially treated drug induced SCLE.)Tj
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(DISCUSSION)Tj
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(Idiopathic SCLE occurs most often in women aged 15 to 40)Tj
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(years)Tj
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(1,2)Tj
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[(. )17.8 (There appears to be a genetic contribution to patho-)]TJ
0.0112 Tw -2.9219 -1.2 Td
(genesis, as patients with anti-Ro positive SCLE manifest an)Tj
0.2379 Tw T*
(increased frequency of HLA-DR2 and -DR3 expression.)Tj
-0.0125 Tw T*
[(While renal, vascular)39.7 (, and central nervous system complica-)]TJ
0.1376 Tw T*
[(tions are unlikely)64.8 (, half of all patients with SCLE develop)]TJ
0.06731 Tw T*
(arthralgia, fatigue, leukopenia, or other signs that are more)Tj
0.24001 Tw T*
(typically associated with SLE)Tj
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(1)Tj
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(. Roughly 60\32080% of the)Tj
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[(patients will have a positive )54.8 (ANA)-376.3 (and anti-Ro/SSA)-376.3 (anti-)]TJ
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(body; they may or may not be positive for anti-dsDNA)Tj
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(. A)Tj
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(variety of drugs have been reported to cause or to exacerbate)Tj
0.1925 Tw T*
(SCLE, but these are the first cases of docetaxel induced)Tj
0.14391 Tw T*
(SCLE to our knowledge. Evidence to implicate docetaxel)Tj
0.0015 Tw T*
(includes the temporal association between administration of)Tj
0.1488 Tw T*
(the drug and onset of lesions, resolution upon drug with-)Tj
0.02499 Tw T*
(drawal, and exacerbation and recurrence upon rechallenge.)Tj
0.0722 Tw 1.2 -1.2 Td
(Docetaxel is a chemotherapeutic agent used as first-line)Tj
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[(treatment in metastatic breast carcinoma. )17.7 (T)69.9 (axotere tar)17.7 (gets)]TJ
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(actively replicating cells by disrupting microtubule)Tj
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(assembly and disassembly \(tubulin polymerization\), bcl-2)Tj
0.22479 Tw T*
(phosphorylation inactivation, and CPP32 cleavage)Tj
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(15)Tj
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(. The)Tj
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(cycling cells are arrested in the G2/M phase and subse-)Tj
0.2771 Tw T*
(quently die by apoptosis)Tj
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(15)Tj
-0.00011 Tc 0.27699 Tw 10 0 0 10 166.2961 202.1292 Tm
(. It is possible that docetaxel)Tj
0.26151 Tw -11.2296 -1.2 Td
[(induces SCLE through its proapoptotic ef)17.7 (fects on repli-)]TJ
0.2233 Tw T*
[(cating cells. )54.8 (Apoptosis results in release of nucleosomes)]TJ
0.1425 Tw T*
[(postulated to be tar)17.7 (get antigens in LE)]TJ
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(15)Tj
-0.00011 Tc 0.1425 Tw 10 0 0 10 218.2711 166.1292 Tm
[(. )17.7 (The treatment of)]TJ
0.0708 Tw -16.4271 -1.2 Td
(LE-prone mice with docetaxel has been associated with an)Tj
0.15919 Tw 26.4 55.9032 Td
(increase in circulating nucleosomes followed by aggrava-)Tj
0.1066 Tw T*
(tion of glomerulonephritis)Tj
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(15)Tj
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(. It seems reasonable to postu-)Tj
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(late that rapidly replicating keratinocytes, when subjected to)Tj
0.1875 Tw T*
[(the cytotoxic ef)17.7 (fects of docetaxel, would also manifest a)]TJ
0.1088 Tw T*
(nucleosome release followed by a local autoimmune reac-)Tj
0 Tw T*
(tion.)Tj
0.0869 Tw 1.2 -1.2 Td
(The treatment of idiopathic SCLE is typically low dose)Tj
0.1281 Tw -1.2 -1.2 Td
(systemic steroids and/or photoprotection. In cases of drug)Tj
0.16541 Tw T*
[(based etiology)64.8 (, drug cessation is critical for resolution of)]TJ
0 Tw T*
(lesions.)Tj
/T1_3 1 Tf
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(REFERENCES)Tj
/T1_2 1 Tf
0.02499 Tw 8 0 0 8 325 571.1616 Tm
[(1.)-875.1 (Crowson )54.8 (AN, Magro CM. )17.7 (The cutaneous pathology of lupus)]TJ
1.675 -1.25 Td
(erythematosus. J Cutan Pathol 2001;28:1-23.)Tj
-1.675 -1.25 Td
[(2.)-875.1 (Magro CM, Crowson )54.8 (AN, Harrist )17.7 (TJ. )17.7 (The use of antibody to C5b-9)]TJ
1.675 -1.25 Td
(in the subclassification of lupus erythematosus. Br J Dermatol)Tj
0 Tc 0 Tw 0 -1.25 TD
(1996;134:855-62.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(3.)-875.1 (Goodrich )54.8 (AL, Kohn SR. Hydrochlorothiazide-induced lupus )]TJ
1.675 -1.25 Td
[(erythematosus: a new variant? J )54.8 (Am )54.8 (Acad Dermatol )]TJ
0 Tc 0 Tw T*
(1993;28:1001-2.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(4.)-875.1 (Darken M, McBurney EI. Subacute cutaneous lupus )]TJ
1.675 -1.25 Td
(erythematosus-like drug eruption due to combination diuretic)Tj
T*
[(hydrochlorothiazide and triamterene. J )54.8 (Am )54.8 (Acad Dermatol)]TJ
0 Tc 0 Tw T*
(1988;18:38-42.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(5.)-875.1 (Srivastava M, Rencic )54.8 (A, Diglio G, et al. Drug-induced, )]TJ
1.675 -1.25 Td
[(Ro/SSA-positive cutaneous lupus erythematosus. )54.8 (Arch Dermatol)]TJ
0 Tc 0 Tw T*
(2003;139:45-9.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(6.)-875.1 (Crowson )54.8 (AN, Magro CM. Diltiazem and subacute cutaneous lupus)]TJ
1.675 -1.25 Td
(erythematosus-like lesions [letter]. New Engl J Med)Tj
0 Tc 0 Tw T*
(1995;333:1429.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(7.)-875.1 (Crowson )54.8 (AN, Magro CM. Subacute cutaneous lupus erythematosus)]TJ
1.675 -1.25 Td
[(in the setting of calcium channel blocker therapy)64.8 (. Hum Pathol)]TJ
0 Tc 0 Tw T*
(1997;28:67-73.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(8.)-875.1 (Ross S, Ormerod )54.8 (AD, Roberts C, Dwyer C, Herriot R. Subacute)]TJ
1.675 -1.25 Td
(cutaneous lupus erythematosus associated with phenytoin. Clin Exp)Tj
T*
(Dermatol 2002;27:474-6.)Tj
-1.675 -1.25 Td
[(9.)-875.1 (Bleumink GS, ter Bor)17.7 (g EJ, Ramselaar CG, Ch Stricker BH.)]TJ
1.675 -1.25 Td
(Etanercept-induced subacute cutaneous lupus erythematosus.)Tj
T*
(Rheumatology Oxford 2001;40:1317-9.)Tj
-2.175 -1.25 Td
[(10.)-875.1 (T)69.9 (oll )54.8 (A, Campo-Pisa P)110.7 (, Gonzalez-Castro J, et al. Subacute cutaneous)]TJ
2.175 -1.25 Td
(lupus erythematosus associated with cinnarizine and thielylperazine)Tj
0 Tc T*
[(therapy)64.9 (. Lupus 1998;7:364-6.)]TJ
-0.00011 Tc -2.1381 -1.25 Td
[(1)36.8 (1)-0.1 (.)-875.1 (Crowson )54.8 (AN, Magro CM. Lichenoid and subacute cutaneous lupus)]TJ
2.1381 -1.25 Td
[(erythematosus-like dermatitis associated with antihistamine therapy)64.8 (.)]TJ
T*
(J Cutan Pathol 1999;26:95-9.)Tj
-2.175 -1.25 Td
[(12.)-875.1 (Ghate JV)128.8 (, )17.7 (T)35 (urner ML, Rudek MA, et al. Drug-induced lupus )]TJ
2.175 -1.25 Td
[(associated with COL-3. )54.8 (Arch Dermatol 2001;137:471-4.)]TJ
-2.175 -1.25 Td
[(13.)-875.1 (Bonsmann G, Schiller M, Luger )17.7 (T)79.9 (A, Stander S. )]TJ
2.175 -1.25 Td
[(T)69.9 (erbinafine-induced subacute cutaneous lupus erythematosus. J )54.8 (Am)]TJ
T*
(Acad Dermatol 2001;44:925-31.)Tj
-2.175 -1.25 Td
[(14.)-875.1 (Murphy M, Barnes L. )17.7 (T)69.9 (erbinafine-induced lupus erythematosus. Br)]TJ
2.175 -1.25 Td
(J Dermatol 1998;138:708-9.)Tj
-2.175 -1.25 Td
[(15.)-875.1 (Stollar BD, Stephenson F)79.7 (.)-0.1 ( )54.8 (Apoptosis and nucleosomes. Lupus)]TJ
0 Tw 2.175 -1.25 Td
[(2002;1)36.8 (1:787-9.)]TJ
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