Lobular neutrophilic panniculitis associated with DNA methyltransferase inhibitors in the treatment of myeloid disease

J Cutan Pathol. 2019 Dec;46(12):930-934. doi: 10.1111/cup.13537. Epub 2019 Aug 26.

Abstract

Cutaneous toxicities to DNA methyltransferase inhibitors are variable and include localized injection site reactions, ecchymoses, maculopapular eruptions, and neutrophilic dermatoses including pyoderma gangrenosum, Sweet syndrome, and neutrophilic eccrine hidradenitis. This series describes two patients diagnosed with lobular neutrophilic panniculitis arising during treatment of acute myelogenous leukemia with "hypomethylating drugs," including the first report of its occurrence with a next-generation agent. Differential diagnoses, histopathologic characteristics, treatment considerations, and proposed pathogenesis will be discussed.

Keywords: DNA methyltransferase inhibitors; acute myelogenous leukemia; lobular neutrophilic panniculitis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Agents / toxicity*
  • Azacitidine / administration & dosage
  • Azacitidine / analogs & derivatives*
  • Azacitidine / therapeutic use
  • Azacitidine / toxicity*
  • DNA
  • Diagnosis, Differential
  • Drug-Related Side Effects and Adverse Reactions / pathology
  • Enzyme Inhibitors / administration & dosage
  • Enzyme Inhibitors / therapeutic use
  • Enzyme Inhibitors / toxicity*
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy
  • Male
  • Methyltransferases / antagonists & inhibitors
  • Middle Aged
  • Neutrophils / pathology
  • Panniculitis / chemically induced*
  • Panniculitis / pathology
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use
  • Skin Diseases / chemically induced*
  • Skin Diseases / pathology
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Enzyme Inhibitors
  • Glucocorticoids
  • guadecitabine
  • DNA
  • Methyltransferases
  • Azacitidine
  • Prednisone