Lichenoid inflammation of DSAP lesions following treatment with durvalumab, olaparib and paclitaxel: A potential diagnostic pitfall mimicking lichenoid drug eruptions associated with PDL-1 inhibitors

Dermatol Online J. 2020 Mar 15;26(3):13030/qt7nf6c8hc.

Abstract

Disseminated superficial actinic porokeratosis (DSAP) is an uncommon skin condition that can be inherited or may occur sporadically with multiple red-brown, thin plaques in a photodistribution. The condition more often affects middle-aged women and is often recalcitrant to therapy. In rare literature reports, systemic medications can trigger exacerbation or promote inflammation in pre-existing lesions of DSAP. We present a novel case of chemotherapy-associated DSAP inflammation in a 66-year-old woman after triple therapy with durvalumab (PD-L1 inhibitor), olaparib (PARP inhibitor) and paclitaxel, showing similarities to primary lichen planus-like eruption from immune checkpoint inhibitors.

MeSH terms

  • Aged
  • Antibodies, Monoclonal / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy
  • Diagnosis, Differential
  • Drug Eruptions
  • Female
  • Humans
  • Inflammation / chemically induced
  • Inflammation / diagnosis*
  • Lichenoid Eruptions / diagnosis*
  • Paclitaxel / adverse effects*
  • Phthalazines / adverse effects*
  • Piperazines / adverse effects*
  • Porokeratosis / complications
  • Porokeratosis / pathology*
  • Skin / pathology

Substances

  • Antibodies, Monoclonal
  • Phthalazines
  • Piperazines
  • durvalumab
  • Paclitaxel
  • olaparib