Reactions 1704, p292 - 2 Jun 2018 ★ S First report of Stevens Johnson syndrome: case report A 63-year-old woman developed Stevens-Johnson syndrome (SJS) during treatment with palbociclib for breast cancer [route and dosage not stated; time to reaction onset not clearly stated]. The woman, who had breast cancer, presented with a three- week history of a worsening and painful rash. The symptoms started on her face and spread to her trunk and extremities after six weeks palbociclib treatment. She also received concomitant therapy with fulvestrant. She reported taking palbociclib five days before the presentation. She reported experiencing malaise, dysuria and a gritty sensation in her eyes. Her history was significant for psoriatic arthritis. Physical examination revealed pink-to-violaceous, eroded, tender plaques with collarettes of scale on the face, trunk and legs. Nikolsky sign became positive the following day. Skin biopsy revealed vacuolar interface dermatitis, focal full-thickness epidermal necrosis and mild superficial perivascular lymphocytic infiltrate with pigment incontinence and dermal oedema. Based on the clinical findings and Nikolsky sign, a diagnosis of SJS was made. Palbociclib was considered to be the likely cause of SJS. The woman received treatment with ciclosporin [cyclosporine], which reduced the progression of her lesions. At one month follow-up, her symptoms had resolved. Author comment: "We cannot completely exclude other potential causes of SJS. She had tolerated her other medications, including fulvestrant, for years without cutaneous adverse effects. Using the algorithm for drug causality for epidermal necrolysis developed by Sassolas et al, the score for palbociclib was 3, suggesting possible cause". Karagounis T, et al. Stevens-Johnson syndrome-like eruption from palbociclib in a patient with metastatic breast cancer. JAAD Case Reports 4: 452-454, No. 5, Jun 2018. Available from: URL: http://doi.org/10.1016/j.jdcr.2017.12.015 - USA 803322988 » Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of Stevens- Johnson syndrome associated with palbociclib. The WHO ADR database did not contain any reports of Stevens-Johnson syndrome associated with palbociclib. 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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