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Aromatase inhibitor-induced skin adverse reactions: exemestane-related cutaneous vasculitis.

Author(s): Santoro S, Santini M, Pepe C, Tognetti E, Cortelazzi C, Ficarelli E, De Panfilis G

Affiliation(s): Department of Surgical Sciences, Parma University, Parma, Italy.

Publication date & source: 2011-05, J Eur Acad Dermatol Venereol., 25(5):596-8.

Publication type: Case Reports; Research Support, Non-U.S. Gov't; Review

BACKGROUND: Three aromatase inhibitors, namely anastrozole, letrozole and exemestane, which reduce circulating oestrogen, are used to treat breast cancer patients; the therapeutic use of such aromatase inhibitors is quickly increasing. OBJECTIVE: We intended (i) to review aromatase inhibitor-induced cutaneous adverse effects and (ii) to describe a recently observed case of cutaneous vasculitis triggered by exemestane. PATIENTS/METHODS: The so-far reported literature cases of aromatase inhibitor-induced cutaneous adverse effects were analysed retrospectively. Especially, the clinical case of exemestane-induced cutaneous vasculitis herein reported is unique, because such an observation has not yet been published in the literature. RESULTS: Merely 12 cases of cutaneous adverse reactions induced by aromatase inhibitors, namely erythema nodosum (6), subacute cutaneous lupus erythematosus (1), cutaneous rashes (2), vasculitis (3, including the one described in this study), are reported in the literature. In fact, in the present case, cutaneous vasculitis was strictly related to exemestane. CONCLUSION: As aromatase inhibitors (e.g. exemestane) are increasingly incorporated into the treatment strategy of breast cancer patients, it is important to recognize possible cutaneous adverse effects. Specifically, with regard to cutaneous vasculitis, some patients might progress to severe vasculitis manifestations if the offending drug (e.g. exemestane) is not quickly stopped. (c) 2010 The Authors. Journal of the European Academy of Dermatology and Venereology (c) 2010 European Academy of Dermatology and Venereology.

Page last updated: 2011-12-09

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