Case Report

Lichenoid Dermatts Afer Hypofractonated Radiaton Therapy for Breast Cancer

Abstract

Lichenoid dermatitis is a rare complication after radiation therapy and is often considered as a delayed hypersensitivity reaction. It is different from lichen planus and is characterized by fine white scale (Wickham’s striae). Here, we report a case of lichenoid dermatitis developed after hypofractionated whole-breast radiation therapy followed by breast-conserving surgery. A 60-year-old female patient underwent hypofractionated whole-breast radiation therapy followed by a boost to the tumor bed. Post-radiation course was uneventful, but violaceous, polyangular, and pruritic papules accompanied by the eruption were noted at the boost site. Clinical findings were consistent with lichenoid dermatitis, so steroid ointment and oral antihistamines were administered. Her lichenoid dermatitis was completely relieved in 2 weeks, and there was no sign of relapse during the 5 years follow-up. There are some reports of lichen planus induced after radiotherapy; however, this is the first report that shows lichenoid dermatitis as a possible complication after hypofractionated radiation therapy for breast cancer.

[1] Paterson JW. The spectrum of lichenoid dermatts. Journal of Cutaneous Pathology. 1991; 18(2):67-74. [DOI:10.1111/j.1600-0560.1991.tb00130.x] [PMID]
[2] Okiyama N, Fujimoto M. Clinical perspectves and murine models of lichenoid tssue reacton/interface dermatts. Journal of Dermatological Science Impact Factor. 2015; 78(3):167-72. [DOI:10.1016/j. jdermsci.2015.03.001] [PMID]
[3] Gru AA, Salavaggione AL. Lichenoid and interface dermatoses. Seminars in Diagnostc Pathology. 2017; 34(3):237-49. [DOI:10.1053/j.semdp.2017.03.001] [PMID]
[4] Sehgal VN, Srivastava G, Sharma S, Sehgal S, Verma P. Lichenoid tssue reacton/interface dermatts: Recogniton, classifcaton, etology, and clinicopathological overtones. Indian Journal of
Dermatology, Venereology and Leprology. 2011; 77(4):418-29. [DOI:10.4103/0378-6323.82389] [PMID]
[5] Jagsi R, Grifth KA, Boike TP, Walker E, Nurushev T, Grills IS, et al. Differences in the acute toxic effects of breast radiotherapy by fractonaton schedule: comparatve analysis of physician assessed and patent-reported outcomes in a large multcenter cohort. JAMA Oncology. 2015; 1(7):918-30. [DOI:10.1001/jamaoncol.2015.2590]
[PMID]
[6] Valle LF, Agarwal S, Bickel KE, Herchek HA, Nalepinski DC, Kapadia NS. Hypofractonated whole breast radiotherapy in breast conservaton for early-stage breast cancer: A systematc review and meta-analysis of randomized trials. Breast Cancer Research and Treatment. 2017; 162(3):409-17. [DOI:10.1007/s10549-017-4118-
7] [PMID]
[7] Haviland JS, Mannino M, Grifn C, Porta N, Sydenham M, Bliss JM, et al. Late normal tssue effects in the arm and shoulder following lymphatc radiotherapy: Results from the UK START (Standardisaton of Breast Radiotherapy) trials. Radiotherapy and Oncology. 2018; 126(1):155-162. [DOI:10.1016/j.radonc.2017.10.033] [PMID] [PMCID]
[8] Tilly JJ, Drolet BA, Esterly NB. Lichenoid eruptons in children. Journal of the American Academy of Dermatology. 2004; 51(4):606-24. [DOI:10.1016/j.jaad.2003.12.012] [PMID]
[9] Kumar U M, Yelikar BR, Inamadar AC, Umesh S, Singhal A, Kushtagi AV. A clinico-pathological study of lichenoid tssue reactons-a tertary care experience. Journal of Clinical and Diagnostc Research. 2013; 7(2):312-6. [DOI:10.7860/JCDR/2013/5110.2755] [PMID] [PMCID]
[10] Coleman E, Ko C, Dai F, Tomayko MM, Kluger H, Leventhal JS. Inflammatory eruptons associated with immune checkpoint inhibitor therapy: A single-insttutonal, retrospectve analysis with stratfcaton of reactons by toxicity and implicatons for management. Journal of the American Academy of Dermatology. 2019; 80(4):990-7. [DOI:10.1016/j.jaad.2018.10.062] [PMID] [PMCID]
[11] Kluger N. Radiaton-associated lichen planus: A case report and literature review. Acta Dermatovenerologica Alpina, Panonica, et Adriatca. 2017; 26(4):105-8. [DOI:10.15570/actaapa.2017.30] [PMID]
[12] Lan J, Li R, Yin LM, Deng L, Gui J, Chen BQ, et al. Targetng myeloidderived suppressor cells and programmed death ligand 1 confers therapeutc advantage of ablatve hypofractonated radiaton therapy compared with conventonal fractonated radiaton therapy. Internatonal Journal of Radiaton Oncology, Biology, Physics. 2018; 101(1):74-87. [DOI:10.1016/j.ijrobp.2018.01.071] [PMID]
[13] Gupta A, Ohri N, Hafy BG. Hypofractonated radiaton treatment in the management of breast cancer. Expert Review of Antcancer Therapy. 2018; 18(8):793-803. [DOI:10.1080/14737140.2018.1489 245] [PMID] [PMCID]
[14] Lee JH, Yi HW, Bae SY, Lee SK, Kil WH, Kim SW, et al. Hormonal receptor positvity and clinical multfocality are independent predisposing factors for positve margin events in breast-conserving surgery afer neoadjuvant chemotherapy. Journal of Breast Disease. 2015; 3(1):8-15. [DOI:10.14449/jbd.2015.3.8]
[15] Nanda A, Al-Ajmi HS, Al-Sabah H, Al-Hasawi F, Alsaleh QA. Childhood lichen planus: A report of 23 cases. Pediatric Dermatology. 2001; 2001(1);18:1-4. [DOI:10.1046/j.1525- 1470.2001.018001001.x] [PMID]
Files
IssueVol 4 No 3 (2019): Summer QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/crcp.v4i3.1717
Keywords
Adverse Events Breast Carcinoma Dermatitis Radiotherapy.

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How to Cite
1.
Hama Y, Tate E. Lichenoid Dermatts Afer Hypofractonated Radiaton Therapy for Breast Cancer. CRCP. 2019;4(3):94-97.