Desquamative skin rash associated with temozolomide in a patient with glioblastoma

Farshchian, Mehdi; Bardhi, Redina; Daveluy, Steven

doi:10.1111/dth.14771

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…However, when assessing the integrity of the cornified cell envelope in the stratum granulosum, a notable reduction and discontinuation in loricrin expression were observed in explants subjected to higher doses of the AG trigger, as compared to the control (Figure 2). This observation aligns with prior findings in patients diagnosed with papulopustular rosacea (PPR) [24], a condition often characterized by facial erythema and telangiectasia (spider vein) [25]. LL37 is an antimicrobial peptide with pleiotropic effects; it can modulate inflammation as well as vasculogenesis and plays a significant role in the development of rosacea [25,25].…”

Section: Inflammatory Triggers Resulted In Compromised Epidermal Barriersupporting

confidence: 89%

The Development of Human Ex Vivo Models of Inflammatory Skin Conditions

Wang,

Barresi-Thornton,

Chen

et al. 2023

IJMS

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Traditional research in inflammatory dermatoses has relied on animal models and reconstructed human epidermis to study these conditions. However, these models are limited in replicating the complexity of real human skin and reproducing the intricate pathological changes in skin barrier components and lipid profiles. To address this gap, we developed experimental models that mimic various human inflammatory skin phenotypes. Human ex vivo skins were stimulated with various triggers, creating models for inflammation-induced angiogenesis, irritation response, and chronic T-cell activation. We assessed the alterations in skin morphology, cellular infiltrates, cytokine production, and epidermal lipidomic profiles. In the pro-angiogenesis model, we observed increased mast cell degranulation and elevated levels of angiogenic growth factors. Both the irritant and chronic inflammation models exhibited severe epidermal disruption, along with macrophage infiltration, leukocyte exocytosis, and heightened cytokine levels. Lipidomic analysis revealed minor changes in the pro-angiogenesis model, whereas the chronic inflammation and irritant models exhibited significant decreases in barrier essential ceramide subclasses and a shift toward shorter acyl chain lengths (<C18), indicating skin barrier instability. Additionally, the irritant and chronic inflammation models are responsive to immunosuppressants. These models hold promise for advancing scientific understanding and the development of therapeutic and skincare solutions for individuals afflicted by compromised skin conditions.

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Section: Inflammatory Triggers Resulted In Compromised Epidermal Barriersupporting

confidence: 89%

The Development of Human Ex Vivo Models of Inflammatory Skin Conditions

Wang,

Barresi-Thornton,

Chen

et al. 2023

IJMS

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“…Persistent erythema and telangiectasias are not entirely secondary to inflammation and often need treatment directed at the skin vasculature, such as brimonidine, oxymetazoline, or vascular lasers. Phymatous changes in rosacea result in irreversible skin changes that require surgical intervention if necessary (8,34,35).…”

Section: Treatmentmentioning

confidence: 99%

“…Systemic management is usually used for flare-ups with no response to individual topical therapy. It is preferable to maintain topical management so that remission remains after flare-up control (1,8,23,(36)(37)(38).…”

Section: Procedures/interventionsmentioning

confidence: 99%

“…➢ Keratosis pilaris rubra usually occurs in adolescent individuals with small follicular papules on the lateral cheeks and neck over erythematous patches. ➢ Drug-induced acneiform eruption: with abrupt onset and related to drug intake, the skin changes are usually monomorphic, bony at the same stage and also involve the trunk (8).…”

Section: Differential Diagnosismentioning

confidence: 99%

“…Fixed centrofacial erythema and phymatous changes are particularly considered as diagnostic criteria for rosacea. Rosacea in most cases is not a life-threatening disease, with a very good overall prognosis (1)(2)(3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

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Chronic Inflammatory Dermatosis: Rosacea, Overview, Description, Presentation, Epidemiology, Pathophysiology, Types, Differential Diagnosis, Treatment of the Disease and Its Role in Pregnancy

Bryam Esteban Coello García,

María Belén Gutama Baculima,

Barbara Tatiana Reyes Moscoso

et al. 2023

EPRA

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Introduction: Rosacea is a chronic inflammatory dermatosis involving especially the cheeks, nose, chin and forehead, characterized by repetitive episodes of transient flushing or erythema, persistent erythema, in addition to phymatous changes, papules, pustules and telangiectasias. Objective: to detail the current information related to rosacea, description, presentation, epidemiology, pathophysiology, types, differential diagnosis, treatment of the disease and its role in pregnancy. Methodology: a total of 50 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 39 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: rosacea, treatment, chronic inflammatory dermatosis. Results: Phymatous changes are not frequent, however they occur primarily in the nose (rhinophyma) and more commonly in men. Rosacea usually begins between 30 and 50 years of age, however it can occur at any age. The approximate population prevalence is between less than 1 to 22%. The neurocutaneous mechanisms in rosacea, reflecting reactivity to temperature change, alcohol, sports, UV rays and spicy foods, may be mediated by the ankyrin and vanilloid subfamilies of the transient receptor potential (TRP). Increased rosacea can occur in pregnancy and multiple cases linked to rosacea fulminans (RF) are reported in the literature. Conclusions: Rosacea is characterized by repetitive episodes of redness, persistent erythema, inflammatory papules-pustules and telangiectasias. Previously rosacea was divided into ocular, phymatous, fulminant and granulomatous types, however there is now a new classification of rosacea. In the treatment the first thing is to identify the trigger, then make some general recommendations on the skin such as the use of sunscreen and finally give treatment that can be both topical and systemic or even to use laser or other procedures. The differential diagnosis of rosacea is broad and should be carefully analyzed. Treatment in pregnant women is a huge challenge, because several of the treatments for rosacea are contraindicated or have limited evidence of probable side effects to the fetus. KEYWORDS: rosacea,treatment,dermatosis,inflammatory.

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Dexamethasone/temozolomide

2021

Reactions Weekly

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Dexamethasone/temozolomideVarious toxicities: case report A 58-year-old woman developed generalised erythema, skin desquamation and drug eruption during treatment with temozolomide and exhibited masking of cutaneous eruptions secondary to dexamethasone [dosages not stated; not all routes stated].The woman was diagnosed with glioblastoma and received initial treatment with dexamethasone for brain oedema. A month later, brain chemoradiation with a 6-week course of oral temozolomide along with cotrimoxazole [sulfamethoxazole/trimethoprim] for pneumocystis jirovecii prophylaxis. Six weeks after initiation of temozolomide and 12 days after dexamethasone discontinuation, she developed erythema on the face and it progressed to the rest of the body.Treatment with cotrimoxazole and temozolomide were discontinued due to suspected drug reaction. The woman received treatment with methylprednisolone and the rash lasted for 3 weeks.After 4 weeks, the woman received 6 cycles of temozolomide for the first 5 days of a 28-day cycle along with dapsone for pneumocystis jirovecii prophylaxis. However, on the sixth day of the first cycle, she was hospitalised for diffuse erythema of the trunk, face, upper and lower extremities, which progressed to desquamation, particularly on the palms, face and soles. Treatment with dapsone was discontinued due to suspected drug reaction and she received treatment with prednisone. Within three weeks of treatment the rash resolved. However, after four days of a 5-day temozolomide course of the second cycle, she again experienced developed generalised erythematous rash. Thereafter, she underwent successful desensitisation of temozolomide and no recurrence of drug eruption was observed. It was also concluded that the cutaneous eruptions might have been delayed due concomitant dexamethasone therapy.

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Desquamative skin rash associated with temozolomide in a patient with glioblastoma

Cited by 5 publications

References 4 publications

The Development of Human Ex Vivo Models of Inflammatory Skin Conditions

The Development of Human Ex Vivo Models of Inflammatory Skin Conditions

Chronic Inflammatory Dermatosis: Rosacea, Overview, Description, Presentation, Epidemiology, Pathophysiology, Types, Differential Diagnosis, Treatment of the Disease and Its Role in Pregnancy

Dexamethasone/temozolomide

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