ABSTRACT
The Food and Drug Administration approved Ruxolitinib in 2011 for the treatment of primary myelofibrosis. Five-year safety data showed a higher incidence of skin cancer in patients treated with Ruxolitinib compared to best available therapy for myelofibrosis. This report presents a series of five patients with history of myelofibrosis treated with Ruxolitinib who subsequently developed numerous skin cancers with aggressive biological behavior. Each patient in this report was treated by a Mohs surgeon affiliated with an academic institution. All patients had a history of myelofibrosis and were exposed to Ruxolitinib. Some patients were exposed to other immunomodulatory medications such as Hydroxyurea and Rituximab. The total number of skin cancers and skin cancers with particularly aggressive behavior were noted. All five patients in this series developed numerous skin cancers with aggressive biological behavior during or after therapy with Ruxolitinib. Also, one patient developed lentigo maligna melanoma and another developed metastatic undifferentiated pleomorphic sarcoma. The repeat observation of skin cancers with aggressive features during JAK inhibitor treatment suggests that these medications may promote cutaneous malignant transformation in at risk patients. Further surveillance and testing of JAK kinases regarding the risk of skin cancers is indicated.
J Drugs Dermatol. 2017;16(5):508-511.
.Subject(s)
Janus Kinase Inhibitors/administration & dosage , Pyrazoles/administration & dosage , Skin Neoplasms/diagnosis , Skin Neoplasms/drug therapy , Administration, Intravenous , Aged , Humans , Male , Middle Aged , Nitriles , Pyrimidines , Treatment OutcomeABSTRACT
Primary mucinous carcinoma is a rare malignant tumor that most frequently occurs in the periorbital area. This tumor originates from the deepest portion of the eccrine sweat duct. This normally asymptomatic and slow-growing tumor has demonstrated a local recurrence rate of 30% after excision with narrow surgical margins and can have local metastases. It is difficult to differentiate this tumor histologically from metastatic lesions. Immunohistochemical staining and cytokeratin profiles have been studied to aid in the differentiation between primary lesions and metastatic mucinous carcinomas. We present a case of a 54-year-old man with recurrent primary eccrine mucinous carcinoma and review the clinical, histologic, and immunohistochemical features of this tumor.
