Histologic patterns of polyethylene glycol-liposomal doxorubicin-related cutaneous eruptions

The American Journal of Dermatopathology
Francois M CadyJohn S Metcalf

Abstract

Polyethylene glycol (PEG)-liposomal doxorubicin (Stealth R, Doxil) is a formulation of doxorubicin, which is encapsulated in liposomes formulated with PEG. It is favored in the palliative setting over doxorubicin because of its generally favorable side effect profile. Adverse reactions are predominantly skin eruptions. We report 3 cases of women with breast cancer undergoing treatment with liposomal doxorubicin who developed palmar-plantar erythrodysesthesia and diffuse morbilliform eruptions. Biopsies in the 2 cases demonstrated vacuolar interface dermatitis with epidermal dysmaturation and the third case suggested a drug eruption. Additionally, we report a woman with metastatic breast cancer who developed a similar morbilliform eruption soon after completing a regimen of liposomal doxorubicin. The biopsy revealed an atypical squamous proliferation showing epidermal dysmaturation with focal evidence of interface damage. Both clinician and pathologist alike should be cognizant of this cutaneous eruption, as well as the histologic patterns.

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Citations

May 22, 2009·Actas dermo-sifiliográficas·B MonteagudoM M Used-Aznar
May 1, 2008·Journal of Drug Targeting·Crispin R Dass, Peter F M Choong
May 26, 2007·Journal of Controlled Release : Official Journal of the Controlled Release Society·Hee Dong HanByung Cheol Shin
Mar 2, 2010·Oncology Nursing Forum·Karen K Swenson, Elaine M Bell
Mar 13, 2014·The American Journal of Dermatopathology·Julia DaiEmily Y Chu
Jul 8, 2008·Journal of Drug Targeting·Crispin R Dass, Peter F M Choong
Mar 17, 2021·Journal of the European Academy of Dermatology and Venereology : JEADV·T GambichlerR Stranzenbach

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