March-Rodriguez Álvaro, Bellosillo Beatriz, Álvarez-Larrán Alberto, Besses Carles, Pujol Ramon M, Toll Agustí
Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
Department of Pathology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
Ann Dermatol. 2019 Apr;31(2):204-208. doi: 10.5021/ad.2019.31.2.204. Epub 2019 Feb 28.
Ruxolitinib is a Janus kinase (JAK)1 and JAK2 inhibitor approved for the treatment of myelofibrosis and for polycythemia patients who are resistant or intolerant to hydroxyurea. We report a 72 year-old man patient with polycythemia vera who developed multiple cutaneous squamous cell carcinomas (cSCCs) with keratoacanthoma-like histological features while on treatment with ruxolitinib. Similar lesions have been reported in an isolated patient who also received ruxolitinib. Our case confirms that ruxolitinib may induce eruptive cSCCs with characteristic clinical and histological features that differentiate them from conventional non-drug induced lesions. Moreover, we performed a mutational panel analysis of the tumors. The lack of specific mutations in these tumors suggests an impairment of immunosurveillance in the origin of the cutaneous lesions. Frequent and thorough dermatological examinations in patients receiving ruxolitinib with a history of photodamage, skin cancer and/or previous hydroxyurea intake is thus recommended.
芦可替尼是一种获批用于治疗骨髓纤维化以及对羟基脲耐药或不耐受的真性红细胞增多症患者的Janus激酶（JAK）1和JAK2抑制剂。我们报告了一名72岁的真性红细胞增多症男性患者，在接受芦可替尼治疗期间出现了具有角化棘皮瘤样组织学特征的多发性皮肤鳞状细胞癌（cSCC）。在另一名同样接受芦可替尼治疗的孤立患者中也报告了类似病变。我们的病例证实，芦可替尼可能诱发具有特征性临床和组织学特征的暴发性cSCC，使其有别于传统的非药物诱导性病变。此外，我们对肿瘤进行了突变分析。这些肿瘤中缺乏特定突变表明皮肤病变起源时免疫监视功能受损。因此，建议对有光损伤、皮肤癌病史和/或既往服用过羟基脲的接受芦可替尼治疗的患者进行频繁且全面的皮肤科检查。
