title: Histologic patterns of polyethylene glycol-liposomal doxorubicin-related cutaneous eruptions.
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.
authors.affiliation: Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Francois M
authors.initials: FM
authors.lastname: Cady
authors.forename: Rayna
authors.initials: R
authors.lastname: Kneuper-Hall
authors.forename: John S
authors.initials: JS
authors.lastname: Metcalf
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000188:drug therapy; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy; D004317:Doxorubicin / Q000009:adverse effects*; D004337:Drug Carriers; D003875:Drug Eruptions / Q000473:pathology*; D004817:Epidermis / Q000473:pathology; D004890:Erythema / Q000139:chemically induced; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D005533:Foot Dermatoses / Q000139:chemically induced; D006229:Hand Dermatoses / Q000139:chemically induced; D006801:Humans; D008081:Liposomes; D008875:Middle Aged; D010166:Palliative Care; D010292:Paresthesia / Q000139:chemically induced; D011092:Polyethylene Glycols
chemical_list: D004337:Drug Carriers; D008081:Liposomes; D011092:Polyethylene Glycols; D004317:Doxorubicin