Markers of systemic involvement and death in hospitalized cancer patients with severe cutaneous adverse reactions.
J Am Acad Dermatol
; 80(3): 608-616, 2019 Mar.
Article
in En
| MEDLINE
| ID: mdl-30612984
ABSTRACT
BACKGROUND:
Severe cutaneous adverse reactions (SCARs) are frequent in inpatient oncology. Early intervention might reduce morbidity, mortality, and hospitalization costs; however, current clinical and histologic features are unreliable SCAR predictors. There is a need to identify rational markers of SCARs that could lead to effective therapeutic interventions.OBJECTIVE:
To characterize the clinical and serologic features of hospitalized patients with cancer who developed SCARs.METHODS:
Retrospective review of 49 hospitalized cancer patients with a morbilliform rash, recorded testing for serum cytokines (interleukin [IL] 6, IL-10, and tumor necrosis factor [TNF] α) or elafin, and a prior dermatology consultation. Patients were categorized as having a simple morbilliform rash without systemic involvement or complex morbilliform rash with systemic involvement.RESULTS:
Fifteen out of 49 patients (30.6%) were deceased at 6 months from time of dermatologic consultation. Elafin, IL-6, and TNF-α were significantly higher in patients who died compared with patients who were still alive at 6 months. IL-6 and IL-10 were significantly higher in patients with a drug-related complex rash.LIMITATIONS:
Retrospective design, limited sample size, and high-risk patient population.CONCLUSION:
In cancer patients with SCARs, elafin, IL-6, and TNF-α levels might predict a poor outcome. Agents directed against these targets might represent rational treatments for the prevention of fatal SCARs.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cytokines
/
Stevens-Johnson Syndrome
/
Hospital Mortality
/
Elafin
/
Drug Hypersensitivity Syndrome
/
Neoplasms
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
En
Journal:
J Am Acad Dermatol
Year:
2019
Document type:
Article