Abstract：
BACKGROUND: Neutrophilic dermatoses (NDs) often occur secondary to inflammatory conditions, medication exposure, and hematologic malignancy. While malignancy-associated NDs (MA-NDs) have been well reported among those with hematologic cancers, little is known about drug-induced NDs (DI-NDs) within this population. The objective of this study was to compare the presentations and outcomes of patients with hematologic malignancies who developed MA-NDs and DI-NDs.
METHODS: Cases of ND occurring between 2013 and 2023 among those with hematologic malignancies were identified from the electronic medical records of our institution. Patient characteristics, recent medication exposures, cancer mutations, and disease outcomes were reviewed. Patients were categorized with DI-ND if they were recently exposed to one of four medications known to be commonly associated with ND or were otherwise categorized with MA-ND. We report a descriptive analysis of cases of DI-ND and MA-ND.
RESULTS: We identified 52 patients with ND and co-occurring hematologic malignancy including 16 cases of DI-ND (30.8%) and 36 cases of MA-ND (69.2%). The most common ND in both groups was Sweet\'s syndrome. Chronic underlying conditions including solid tumors, inflammatory disorders, chronic viral infection, and tobacco use were more common among those with MA-ND. Among those with DI-ND, tyrosine kinase inhibitors were the most commonly associated drugs (43.8%). The most common cancer mutation among those with DI-ND was FLT3 (43.8%), while the most common mutation among those with MA-ND was TP-53 (19.4%). Among those who had died at the time of data collection, 90.0% of those with DI-ND and 66.7% of those with MA-ND died within 1 year of ND diagnosis.
CONCLUSIONS: Most cases of ND occurring with hematologic malignancies develop secondary to cancer rather than drug exposure. Different cancer mutations may predispose to DI-ND and MA-ND. Further research is needed to establish diagnostic criteria for DI-ND and to determine the pathogenic role of specific cancer mutations, particularly FLT3, in the development of ND.
METHODS: Cases of ND occurring between 2013 and 2023 among those with hematologic malignancies were identified from the electronic medical records of our institution. Patient characteristics, recent medication exposures, cancer mutations, and disease outcomes were reviewed. Patients were categorized with DI-ND if they were recently exposed to one of four medications known to be commonly associated with ND or were otherwise categorized with MA-ND. We report a descriptive analysis of cases of DI-ND and MA-ND.
RESULTS: We identified 52 patients with ND and co-occurring hematologic malignancy including 16 cases of DI-ND (30.8%) and 36 cases of MA-ND (69.2%). The most common ND in both groups was Sweet\'s syndrome. Chronic underlying conditions including solid tumors, inflammatory disorders, chronic viral infection, and tobacco use were more common among those with MA-ND. Among those with DI-ND, tyrosine kinase inhibitors were the most commonly associated drugs (43.8%). The most common cancer mutation among those with DI-ND was FLT3 (43.8%), while the most common mutation among those with MA-ND was TP-53 (19.4%). Among those who had died at the time of data collection, 90.0% of those with DI-ND and 66.7% of those with MA-ND died within 1 year of ND diagnosis.
CONCLUSIONS: Most cases of ND occurring with hematologic malignancies develop secondary to cancer rather than drug exposure. Different cancer mutations may predispose to DI-ND and MA-ND. Further research is needed to establish diagnostic criteria for DI-ND and to determine the pathogenic role of specific cancer mutations, particularly FLT3, in the development of ND.
摘要：
背景：嗜中性粒细胞性皮肤病（ND）通常继发于炎症，药物暴露,和恶性血液病.虽然恶性相关的NDs（MA-NDs）已经在血液系统癌症患者中得到了很好的报道，对该人群中的药物诱导的ND（DI-ND）知之甚少。这项研究的目的是比较发生MA-ND和DI-ND的血液系统恶性肿瘤患者的表现和结果。
方法：从我们机构的电子病历中确定了2013年至2023年血液系统恶性肿瘤患者中发生的中性粒细胞性皮肤病（ND）病例。患者特征,最近的药物暴露，癌症突变，并对疾病结局进行了回顾。如果患者最近暴露于已知通常与ND相关的四种药物之一或被分类为恶性肿瘤相关的ND（MA-ND），则将其分类为药物诱导的ND（DI-ND）。我们报告了DI-ND和MA-ND病例的描述性分析。
结果：我们确定了52例ND和合并恶性血液病患者，包括16例DI-ND（30.8%）和36例MA-ND（69.2%）。两组中最常见的ND是Sweet\'s综合征。慢性基础疾病，包括实体瘤，炎症性疾病，慢性病毒感染，在MA-ND患者中，烟草使用更为常见。在那些有DI-ND的人中，酪氨酸激酶抑制剂是最常见的相关药物(43.8%)。DI-ND患者中最常见的癌症突变是FLT3（43.8％），而MA-ND患者中最常见的突变是TP-53（19.4％）。在收集数据时死亡的人中，90.0%的DI-ND患者和66.7%的MA-ND患者在ND诊断后一年内死亡。
结论：大多数伴有血液系统恶性肿瘤的ND病例继发于癌症，而不是药物暴露。不同的癌症突变可能易患DI-ND和MA-ND。需要进一步的研究来建立DI-ND的诊断标准，并确定特定癌症突变的致病作用，特别是FLT3，在ND的发展。
方法：从我们机构的电子病历中确定了2013年至2023年血液系统恶性肿瘤患者中发生的中性粒细胞性皮肤病（ND）病例。患者特征,最近的药物暴露，癌症突变，并对疾病结局进行了回顾。如果患者最近暴露于已知通常与ND相关的四种药物之一或被分类为恶性肿瘤相关的ND（MA-ND），则将其分类为药物诱导的ND（DI-ND）。我们报告了DI-ND和MA-ND病例的描述性分析。
结果：我们确定了52例ND和合并恶性血液病患者，包括16例DI-ND（30.8%）和36例MA-ND（69.2%）。两组中最常见的ND是Sweet\'s综合征。慢性基础疾病，包括实体瘤，炎症性疾病，慢性病毒感染，在MA-ND患者中，烟草使用更为常见。在那些有DI-ND的人中，酪氨酸激酶抑制剂是最常见的相关药物(43.8%)。DI-ND患者中最常见的癌症突变是FLT3（43.8％），而MA-ND患者中最常见的突变是TP-53（19.4％）。在收集数据时死亡的人中，90.0%的DI-ND患者和66.7%的MA-ND患者在ND诊断后一年内死亡。
结论：大多数伴有血液系统恶性肿瘤的ND病例继发于癌症，而不是药物暴露。不同的癌症突变可能易患DI-ND和MA-ND。需要进一步的研究来建立DI-ND的诊断标准，并确定特定癌症突变的致病作用，特别是FLT3，在ND的发展。
