Targetoid erythema surrounding multiple seborrheic keratoses induced by chemotherapy with gemcitabine.

The cutaneous adverse effects of gemcitabine include allergic skin rash frequently associated with pruritus, alopecia, sweating, dermatitis with boils, and ulcerations. We report the case of a patient that developed inflammation of seborrheic keratoses after gemcitabine treatment.

Nivolumab induced inflammation of seborrheic keratoses: a novel cutaneous manifestation in a metastatic melanoma patient.

Immune checkpoint inhibitors targeting the programmed cell death (PD)-1 receptor have dramatically changed the landscape of metastatic melanoma treatment. Nevertheless, these immuno-modulatory agents have associated side effects, including dermatologic manifestations. To this end, we report a patient with metastatic melanoma that was treated with a PD-1 inhibitor, and subsequently developed inflammation of existing seborrheic keratosis lesions and new verrucous keratoses, a cutaneous side effect that has not been previously reported to our knowledge. The etiology of seborrheic and verrucous keratoses is not well understood, although their physical and histopathologic similarities to chronic viral-derived lesions, such as human papilloma virus, suggest a potential viral association. Chronic viral infections are known to result in T-cell tolerance because of persistent antigen stimulation. PD-1 inhibition is able to reinvigorate exhausted T cells, which are accordingly able to decrease viral load. Thus, the inflammatory reaction, seen in our patient, may be the result of PD-1 inhibition reactivating virally driven T lymphocytes.

Chemotherapy-induced inflammatory seborrheic keratoses in a man with acute myeloid leukemia: a variant of Leser-Trélat sign?

Leser-Trélat sign is a controversial paraneoplastic phenomenon characterized by an eruption of seborrheic keratoses (SKs). We report a rare case of eruptive inflammatory SKs in a man undergoing induction chemotherapy for acute myeloid leukemia (AML). We also review the literature on Leser-Trélat sign.

[Inflammation of multiple seborrheic keratoses induced by chemotherapy with gemcitabine]. / Inflamação de queratoses seborreicas múltiplas induzida por quimioterapia com gencitabina.

There are several common mucocutaneous adverse effects related to chemotherapy, either by direct cytotoxic action or by hypersensitivity to the drugs. The authors report inflammation in multiple seborrheic keratoses after chemotherapy with gemcitabine in a patient under treatment for pancreatic cancer. Moreover, they discuss the relative benignity of this event and warn about the need to correctly identify systemic chemotherapy-induced skin adverse effects.

Inflamação de queratoses seborreicas múltiplas induzida por quimioterapia com gencitabina: [relato de caso] / Inflammation of multiple seborrheic keratoses induced by chemotherapy with gemcitabine: [case report]

São diversos e comuns os efeitos mucocutâneos dos quimioterápicos, alguns por ação citotóxica, outros por hipersensibilidade ao fármaco. Os autores relatam a ocorrência de inflamação em múltiplas queratoses seborreicas pré-existentes, após terapia citorredutora com gencitabina, em paciente sob tratamento para neoplasia de pâncreas. Discutem, ainda, a benignidade do evento e alertam para a necessidade de adequada identificação dos efeitos cutâneos decorrentes da quimioterapia sistêmica.

There are several common mucocutaneous adverse effects related to chemotherapy, either by direct cytotoxic action or by hypersensitivity to the drugs. The authors report inflammation in multiple seborrheic keratoses after chemotherapy with gemcitabine in a patient under treatment for pancreatic cancer. Moreover, they discuss the relative benignity of this event and warn about the need to correctly identify systemic chemotherapy-induced skin adverse effects.

Seborrhoeic keratoses appearing in sites of previous psoriasis plaques during treatment with efalizumab.

A 56-year-old man with recalcitrant psoriasis was treated with efalizumab, resulting in complete clearing of his skin lesions. However, multiple brown patches and papules, in the exact distribution of the previous psoriasis plaques, appeared on his lower legs. The pathological diagnosis was seborrhoeic keratoses (SKs) with overlapping features of solar lentigo. A variety of cutaneous adverse events has been observed in patients with psoriasis treated with efalizumab. To our knowledge, appearance of SKs after such treatment has not previously been reported. This may be due to the clinical insignificance of these benign skin tumours. However, it may be speculated whether efalizumab has an unknown effect in triggering the development of SKs in patients with psoriasis, and if this could shed any light on the pathogenesis of SKs.

Inflammation of seborrheic keratoses caused by cytarabine: a pseudo sign of Leser-Trelat.

Cytarabine, used for the treatment of acute myelogenous leukemia, can cause a rare reaction of inflammation of existing seborrheic keratoses. We report a case of cytarabine induced inflammation of seborrheic keratoses mimicking a vesicular eruption in 53-year-old man with acute myelogenous leukemia.

Transient eruptive seborrheic keratoses associated with erythrodermic psoriasis and erythrodermic drug eruption: report of two cases.

The appearance of multiple seborrheic keratoses in association with underlying internal malignancy (known as the sign of Leser-Trelat) has generated much discussion and debate in the literature. However, comparatively few case reports exist that examine the appearance of multiple seborrheic keratoses associated with exfoliative erythroderma without underlying malignancy. We report 2 cases in which multiple, biopsy-proven seborrheic keratoses appeared in conjunction with erythrodermic skin eruptions. The underlying diseases in these 2 patients included psoriasis and an eczematous drug eruption; in both cases the erythroderma resolved with appropriate treatment. After resolution of the erythroderma, the newly developed seborrheic keratoses proceeded to involute and gradually fall off. Neither of the patients exhibited any evidence of internal malignancy. These cases represent the first reports of psoriasis and drug eruption as causes of erythroderma-induced transient eruptive seborrheic keratoses. Clinical and pathologic findings are consistent with previous descriptions of this entity.

Chemotherapy-induced inflammation in seborrheic keratoses mimicking disseminated herpes zoster.

We report a rare instance of chemotherapy-induced seborrheic keratoses of Leser-Trelat in a patient with acute leukemia. In addition, this is the first known case to mimic disseminated herpes zoster.