Diffuse dermal mucinosis secondary to colony-stimulating factor 1 receptor monoclonal antibody treatment: A novel and peculiar drug-induced diffuse cutaneous mucinosis
Keywords: 
Materias Investigacion::Ciencias de la Salud::Dermatología
Anti-programmed death ligand 1
Colony-stimulating factor 1 receptor inhibitor
Dermal mucinosis
Drug reaction
Skin toxicity
Issue Date: 
2021
Publisher: 
Japanese Dermatological Association
ISSN: 
0385-2407
Citation: 
Olmos-Alpiste, F. (Ferran); Segura, S. (Sonia); Tomás-Velázquez, A. (Alejandra); et al. "Diffuse dermal mucinosis secondary to colony-stimulating factor 1 receptor monoclonal antibody treatment: A novel and peculiar drug-induced diffuse cutaneous mucinosis". Journal of Dermatology. 48, 2021, 380 - 384
Abstract
Colony-stimulating factor 1 receptor (CSF1R) inhibitors represent a new class of immune-modulatory drugs, mostly investigated in clinical trials in different malignant neoplasms. Four patients, diagnosed with recurrent or advanced malignant neoplasm and treated with a combination of anti-programmed death ligand 1 and anti-CSF1R monoclonal antibodies, developed an asymptomatic cutaneous eruption characterized by an ill-defined pseu- doedematous to waxy diffuse infiltration with a reticular cobblestone-like pattern. Histopathological examination revealed diffuse mucin deposition involving the superficial and mid-dermis with fragmented and scattered elastic fibers. The exact pathogenic mechanisms implicated in the development of mucin deposits in patients treated with CSF1R inhibitors remain to be elucidated. A reduced degradation and clearance of components of the extra- cellular matrix by macrophages secondary to CSF1 pathway inhibition may be hypothesized. Shredding and frag- mentation of elastic fibers may be a result of the increased accumulation of mucopolysaccharides. This observation illustrates the new spectrum of skin-related toxicities secondary to new targeting therapies. This may contribute to a better understanding of the underlying pathogenic mechanisms in skin diseases characterized by a persistent dermal glycosaminoglycan deposition.

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