Letrozole-Induced Very Early Systemic Sclerosis in a Patient With Breast Cancer: A Case Report

Pokhai, Gabriel G.; Buzzola, Rino; Abrudescu, Adriana

doi:10.5606/archrheumatol.2014.3429

Cited by 11 publications

(12 citation statements)

References 14 publications

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“…A case of SS in a very early phase was observed by Pokhai et al [131] during AIs therapy. After two years of treatment with Letrozole, the patient reported hand joint pain and stiffness, and two years later, she developed bilateral indurations of the dorsum of the hands and distal vasospastic phenomena exacerbated by exposure to low temperature, consistent with the Raynaud phenomenon.…”

Section: Literature Data On the Association Between Ais And Autoimmunmentioning

confidence: 88%

Aromatase Inhibitors—Induced Musculoskeletal Disorders: Current Knowledge on Clinical and Molecular Aspects

Tenti

Correale

Cheleschi

et al. 2020

IJMS

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Aromatase inhibitors (AIs) have radically changed the prognosis of hormone receptor positive breast cancer (BC) in post-menopausal women, and are a mainstay of the adjuvant therapy for BC after surgery in place of, or following, Tamoxifen. However, AIs aren’t side effect-free; frequent adverse events involve the musculoskeletal system, in the form of bone loss, AI-associated arthralgia (AIA) syndrome and autoimmune rheumatic diseases. In this narrative review, we reported the main clinical features of these three detrimental conditions, their influence on therapy adherence, the possible underlying molecular mechanisms and the available pharmacological and non-pharmacological treatments. The best-known form is the AIs-induced osteoporosis, whose molecular pathway and therapeutic possibilities were extensively investigated in the last decade. AIA syndrome is a high prevalent joint pain disorder which often determines a premature discontinuation of the therapy. Several points still need to be clarified, as a universally accepted diagnostic definition, the pathogenetic mechanisms and satisfactory management strategies. The association of AIs therapy with autoimmune diseases is of the utmost interest. The related literature has been recently expanded, but many issues remain to be explored, the first being the molecular mechanisms.

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Section: Literature Data On the Association Between Ais And Autoimmunmentioning

confidence: 88%

Aromatase Inhibitors—Induced Musculoskeletal Disorders: Current Knowledge on Clinical and Molecular Aspects

Tenti

Correale

Cheleschi

et al. 2020

IJMS

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“…Five women receiving either anastrozole, letrozole, or exemestane also developed vasculitis (Table 2) [4][5][6][7][8]. In addition, various other dermatoses have been observed in patients undergoing treatment with aromatase inhibitors (Table 3) [9][10][11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…The morphology of the other aromatase inhibitor-induced dermatoses-summarized in Table 3 [9-18]-included subacute cutaneous lupus erythematosus (2 women) [9,16], hypersensitivity papular eruption (1 woman-our [11], systemic sclerosis (1 woman) [10], and cutaneous nodulosis (1 woman) [14,19]. The remaining patients' clinical presentation was designated either a grade 2 (1 woman) [13] or a grade 3 (1 woman) [18] skin reaction.…”

Section: Discussionmentioning

confidence: 99%

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Anastrozole-Induced Dermatitis: Report of a Woman with an Anastrozole-Associated Dermatosis and a Review of Aromatase Inhibitor-Related Cutaneous Adverse Events

Kim

Cohen

2020

Dermatol Ther (Heidelb)

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Anastrozole is an aromatase inhibitor. Anastrozole competitively inhibits the aromatase enzyme, which synthesizes estrogen. It is used for estrogen receptor-positive breast cancers. A woman with breast cancer and anastrozole-induced dermatitis is described; the cutaneous side effects associated with aromatase inhibitors are also reviewed. Skin-related adverse events associated with aromatase inhibitor use are uncommon and may be delayed in appearance; the time of onset ranges from less than 5 days to 6 months (median 2 months). They present as either vasculitis, erythema nodosum, subacute cutaneous lupus erythematosus, or other dermatoses. Some patients demonstrate cutaneous lesions at either the original site of the breast malignancy or in areas that were previously treated with surgery or radiotherapy. The skin reactions are usually treated with discontinuation of the aromatase inhibitor; topical corticosteroids or oral corticosteroids or both are also used for some patients. Our patient's drug reaction occurred 2 months after starting the anastrozole and improved after a course of oral and topical corticosteroids. She was able to be switched to an alternate aromatase inhibitor without a recurrence of her adverse skin reaction.

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“…Their relationship with immune disorders such as sicca syndrome, systemic sclerosis and Sjogren syndrome has also been investigated with the latter being more prevalent as reported by Laroche et al Among twenty-four women investigated for joint pain, nineteen were found to have inflammatory pain of the joints and two had inflammatory laboratory profile. Ten patients were diagnosed with sicca syndrome of the eyes or mouth, one was diagnosed with Sjogren syndrome, one RA, and another Hashimoto thyroiditis and seven more were considered to have probable Sjogren syndrome [37] , [38] .…”

Section: Discussionmentioning

confidence: 99%

Aromatase inhibitors induced autoimmune disorders in patients with breast cancer: A review

Zarkavelis

Kollas

Kampletsas

et al. 2016

Journal of Advanced Research

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Letrozole-Induced Very Early Systemic Sclerosis in a Patient With Breast Cancer: A Case Report

Cited by 11 publications

References 14 publications

Aromatase Inhibitors—Induced Musculoskeletal Disorders: Current Knowledge on Clinical and Molecular Aspects

Aromatase Inhibitors—Induced Musculoskeletal Disorders: Current Knowledge on Clinical and Molecular Aspects

Anastrozole-Induced Dermatitis: Report of a Woman with an Anastrozole-Associated Dermatosis and a Review of Aromatase Inhibitor-Related Cutaneous Adverse Events

Aromatase inhibitors induced autoimmune disorders in patients with breast cancer: A review

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