Recall dermatitis after systemic treatment with paclitaxel

Abstract

Background: Recall phenomena of the skin at the site of prior radiation treatment are well established after systemic anti-neoplastic therapy. The aim of this report is to describe a rare clinical entity of recall dermatitis after systemic treatment with paclitaxel without a history of previous radiation at the site of reaction.

Material and methods: A 63-year-old Caucasian female patient treated with paclitaxel because of breast cancer (T3 N1 M0) is presented.

Results: Five days after the fifth-in-a-row infusion swelling and redness occurred on the left arm, where the drug has been administered. The skin changes were interpreted as erysipelas and the patient was treated with systemic antibiotic. One month later, when a new cycle of chemotherapy with paclitaxel was performed, the medication was administered on the opposite (right) arm. Several days after the procedure, the same changes occurred again on the left arm, as in the previous hospitalization. Based on the clinical features and the laboratory findings, diagnosis of "recall dermatitis" was coined. The presented case serves as a basis for discussion on the etiopathogenetic mechanism of the skin recall phenomenon. The drugs associated with the onset of such a reaction are debated.

Conclusion: The specificity of this rare dermatological entity is important for setting up the exact diagnosis and therapeutic approach.