Bullous pemphigoid development during the course of breast cancer: a radiation induced or a radiation recall dermatitis?

Abstract Background: Bullous pemphigoid (BP) is the most common autoimmune bullous disease, which is usually seen in older ages. Rarely, radiotherapy (RT) has been reported as a localised trigger factor for BP. Case: We present a case of a 64-year-old woman who underwent radical mastectomy and radiation therapy for breast cancer. Two months after the completion of RT with adjuvant Trastuzumab, a BP eruption developed in the irradiated area, spreading thereafter to other skin areas. The patient was treated with oral corticosteroids and the lesions evolved favourably. Conclusion: This case demonstrates a relatively benign skin reaction that could develop during the course of cancer treatment, which required co-management by oncologists, pathologists and dermatologists.

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Radiation recall dermatitis after treatment of stage IV breast cancer with nivolumab: a case report

Immunotherapy ◽

10.2217/imt-2019-0020 ◽

2020 ◽

Vol 12 (2) ◽

pp. 123-130 ◽

Cited By ~ 1

Author(s):

Cole Billena ◽

Shilpa Padia ◽

Bridget O’Brien ◽

Jeanna Knoble ◽

Abhay Gokhale ◽

...

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma ◽

Spinal Metastasis ◽

Radical Mastectomy ◽

Multidisciplinary Teams ◽

Adjuvant Radiation ◽

Radiation Recall ◽

Stage Iv Breast Cancer ◽

Radiation Recall Dermatitis ◽

Recall Dermatitis

Radiation recall dermatitis (RRD) is an uncommon dermatologic reaction provoked notably by chemotherapy in an area of skin irradiated weeks to years prior. We report a case of RRD with nivolumab in a woman with breast cancer. The patient was diagnosed with invasive ductal carcinoma of the left breast with an isolated spinal metastasis approached in an oligometastatic fashion with neoadjuvant chemotherapy, modified radical mastectomy and adjuvant radiotherapy. Unfortunately, after progression of bony metastases treated with radiotherapy, the patient received nivolumab and subsequently developed a rash corresponding to the adjuvant radiation field. This case highlights the unpredictable nature and characteristic rash of RRD. It is an important differential diagnosis for multidisciplinary teams who also see chemotherapy-induced dermatitis and immune-related adverse events.

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Recurrent radiation recall dermatitis 40 years after radiation therapy for breast cancer

The Breast Journal ◽

10.1111/tbj.14212 ◽

2021 ◽

Author(s):

Muhammad F. Jamaluddin ◽

Aswin G. Abraham ◽

Geetha Menon ◽

Thomas Nakatsui ◽

Wilson Roa

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Radiation Recall ◽

Radiation Recall Dermatitis ◽

Recall Dermatitis

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Trastuzumab induced radiation recall dermatitis: an interesting case

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20184868 ◽

2018 ◽

Vol 7 (12) ◽

pp. 2465

Author(s):

Anupama C. ◽

Anuradha H. V. ◽

Vinayak V. Maka

Keyword(s):

Ductal Carcinoma ◽

Growth Factor Receptor ◽

Radical Mastectomy ◽

Left Breast ◽

Interesting Case ◽

Axillary Lymph ◽

Radiation Recall ◽

Skin Reactions ◽

Radiation Recall Dermatitis ◽

Recall Dermatitis

Radiation recall dermatitis (RRD) is the appearance of skin reactions in previously irradiated skin which is triggered by the administration of certain drugs. Surgery, chemotherapy, and radiotherapy are the mainstay of treatment in breast cancer. RRD induced by trastuzumab has been rarely reported in India. This is a case report of a 56-year-old woman presented to the medical oncology outpatient department of our hospital with breast lump, and she was diagnosed to have human epidermal growth factor receptor 2 (HER-2/neu) positive invasive ductal carcinoma of left breast of stage T2N3cM0. She was treated with neoadjuvant chemotherapy, and she underwent modified radical mastectomy with axillary lymph node dissection. The treating oncologist was planned to start on adjuvant chemotherapy with injection trastuzumab for every four weeks, for 15 cycles. Patient received first dose of injection trastuzumab (450 mg) intravenously in the right (contralateral) arm and developed painful, swollen, erythematous blisters, and maculopapular rashes following the sharp linear borders of her previous radiation fields. She was reviewed by the medical oncologist and diagnosed as a rare case of RRD and treated with topical betamethasone cream. Causality assessment for RRD to trastuzumab was done using Naranjo and WHO-UMC scale and found to be in the category of probable and probable/ likely respectively.

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