Letter - Therapy
Abemaciclib-induced lichen planus pigmentosus inversus improving after switching to ribociclib
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Infiltrado linfo‐histiocitário com incontinência pigmentar, infiltrado inflamatório em faixa (padrão liquenoide) na derme papilar com exocitose e acantose (Hematoxilina & eosina 100<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>[A] e 400<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>[B]).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Antoine Communie, Isabelle Valo, Patrick Soulié, Xavier Grimaux" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Antoine" "apellidos" => "Communie" ] 1 => array:2 [ "nombre" => "Isabelle" "apellidos" => "Valo" ] 2 => array:2 [ "nombre" => "Patrick" "apellidos" => "Soulié" ] 3 => array:2 [ "nombre" => "Xavier" "apellidos" => "Grimaux" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0365059624001521" "doi" => "10.1016/j.abd.2023.11.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624001521?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001723?idApp=UINPBA00008Z" "url" => "/26662752/0000009900000006/v1_202410301154/S2666275224001723/v1_202410301154/pt/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S0365059624001557" "issn" => "03650596" "doi" => "10.1016/j.abd.2024.02.003" "estado" => "S300" "fechaPublicacion" => "2024-11-01" "aid" => "1002" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter - Therapy</span>" "titulo" => "Nodular scleroderma partially controlled with tofacitinib" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "989" "paginaFinal" => "991" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1168 "Ancho" => 1005 "Tamanyo" => 348075 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histopathology revealed a proliferation of myofibroblasts and thickened sclerotic collagen bundles in the dermis (A, Hematoxylin & eosin ×20; 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Here, we report a case of Lichen Planus Pigmentosus Inversus (LPPi) induced by abemaciclib treatment improving after switching to ribociclib.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 61-year-old woman, who had been treated with abemaciclib for 5 months with a conceded dose of 100 mg/day due to diarrhea was admitted with an asymptomatic flexural pigmentation of the submammary, cubital and inguinal folds. The patient had a Fitzpatrick II skin type and was only taking letrozole and loperamide as other drugs, introduced simultaneously. She showed gray hyperpigmented lesions with papules and desquamation on the flexural areas (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>). There was no mucosal involvement. A punch biopsy on the right thigh showed an acanthotic and ortho-keratotic epidermal layer with intraepidermal pagetoid migration of lymphoid cells, band-like lichenoid lymphocytic infiltrate in the papillary dermis with pigmentary incontinence and melanophage (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>), which confirmed the diagnosis. Abemaciclib was suspended due to the rapidly extensive lesions and digestive toxicity, and the lichenoid drug reaction started to decay after 15 days. Treatment was then switched to ribociclib with the use of topical betamethasone for about a month. The patient stopped using topical corticoids as the hyperpigmented lesions lessened. She has since been treated with ribociclib without any extension of the remaining lesions.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Lichen planus pigmentosus inversus is a rare variant of lichen planus that presents as an acquired symmetrical macular hyperpigmentation featuring gray or blue-brown lesions with erythematous borders in flexural and intertriginous areas, sparing sun-exposed areas. Skin toxicities with CDK4/6 inhibitors consist mostly of alopecia, rash, and pruritus according to a recent review of the US FDA Adverse Event Reporting System by Raschi et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> To date, only one case of lichen planus pigmentosus has been reported with ribociclib by Mariano et al.,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and one case of hyperpigmentation with abemaciclib by Salusti-Samson et al.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Lichen and lichenoid eruptions have also been described with letrozole, but it was excluded in this case because of the improvement without discontinuation of the treatment. LPPi involves cytotoxic T-lymphocytes, but its pathogenesis remains unknown.</p><p id="par0020" class="elsevierStylePara elsevierViewall">It has been reported in association with mechanical trauma, hepatitis C virus, and after COVID-19 vaccination by Chaima et al.,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> which was not the case with our patient. To our knowledge, it is the first reported case of LPPi induced by a CDK4/6 inhibitor that improved after switching to another one. This could be linked to the greater selectivity for CDK4 than CDK6 of abemaciclib versus the others. This suggests that the lichenoid-drug reaction is not a class effect and that a change in the CDK4/6 inhibitor could be a viable option.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0025" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors’ contributions</span><p id="par0030" class="elsevierStylePara elsevierViewall">Antoine Communie: Approval of the final version of the manuscript; preparation and writing of the manuscript; data collection, analysis, and interpretation; critical literature review; manuscript critical review.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Isabelle Valo: Approval of the final version of the manuscript; preparation and writing of the manuscript; intellectual participation in the propaedeutic and/or therapeutic of the studied case; manuscript critical review.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Patrick Soulié: Approval of the final version of the manuscript; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied case; manuscript critical review.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Xavier Grimaux: Approval of the final version of the manuscript; preparation and writing of the manuscript; collection, analysis, and interpretation of data; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied case; critical literature review; manuscript critical review.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Authors’ contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-09-07" "fechaAceptado" => "2023-11-01" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Study conducted at the Institut de Cancérologie de l’Ouest, Angers, France.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1214 "Ancho" => 2508 "Tamanyo" => 424095 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gray hyperpigmented lesions with papules and desquamation in the cubital (A), and lower abdominal fold (B).</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1216 "Ancho" => 2508 "Tamanyo" => 262278 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Bilateral submammary reticular gray hyperpigmented lesions with papules and desquamation (A, B).</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1259 "Ancho" => 2508 "Tamanyo" => 555479 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histopathological findings. Lymphohistiocytic infiltrate with dermal melanin incontinence, lichenoid band-like of the papillary dermis with intraepidermal pagetoid migration and acanthotic epidermal layer. Hematoxylin & eosin ×100 (A) and ×400 (B).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Skin toxicities with cyclin-dependent kinase 4/6 inhibitors in breast cancer: signals from disproportionality analysis of the FDA adverse event reporting system" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Raschi" 1 => "M. Fusaroli" 2 => "M. La Placa" 3 => "A. Ardizzoni" 4 => "C. Zamagni" 5 => "E. 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"fecha" => "2021" "volumen" => "24" "paginaInicial" => "117" "paginaFinal" => "121" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33634626" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A likely case of abemaciclib-induced hyperpigmentation in a patient with metastatic breast cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Salusti-Simpson" 1 => "H. Porter" 2 => "K. Morley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Cureus" "fecha" => "2022" "volumen" => "14" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lichen planus pigmentosus post COVID-19 vaccination: a case report with literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Chaima" 1 => "H. Fatma" 2 => "K. Nadine" 3 => "K. Chahir" 4 => "B. Emna" 5 => "S. Khadija" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Dermatol Ther." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 13 | 5 | 18 |
| 2024 October | 218 | 80 | 298 |
| 2024 September | 171 | 116 | 287 |
| 2024 August | 94 | 114 | 208 |
