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Spider Telangiectases and Palmar Erythema as Harbingers of Structural Liver Changes in Three Breast Cancer Patients on Ado-trastuzumab Emtansine.
J Clin Aesthet Dermatol 2019; 12(7):23-26JC

Abstract

Objective:

We describe three patients treated with ado-trastuzumab emtansine who developed either palmar flushing or spider angiomas. We then correlate these findings with radiologic imaging results of the liver.

Design:

Three consecutive referrals to dermatology for patient skin complaints while taking ado-trastuzumab emtansine were evaluated and found to have either telangiectases or palmar flushing. Two patients who did not have prominent nodularity on computed tomography of the liver underwent transient elastography.

Results:

All three patients with stigmata of liver disease that developed during the course of ado-trastuzumab emtansine demonstrated parenchymal liver abnormalities.

Conclusion:

Patients presenting with spider angiomas and/or palmar flushing on adotrastuzumab emtansine should be considered for elastography studies to ensure early structural damage is not occurring. Further investigation is needed to define the precise etiology for these telangiectases and the role of elastography imaging in monitoring patients on long-term adotrastuzumab emtansine.

Authors+Show Affiliations

Drs. Milam and Kaffenberger are with the Division of Dermatology at The Ohio State University Wexner Medical Center in Columbus, Ohio. Drs. Berger, Ramaswamy, Reinbolt, and Weslowski are with the Division of Medical Oncology at The Ohio State University Comprehensive Cancer Center in Columbus, Ohio.Drs. Milam and Kaffenberger are with the Division of Dermatology at The Ohio State University Wexner Medical Center in Columbus, Ohio. Drs. Berger, Ramaswamy, Reinbolt, and Weslowski are with the Division of Medical Oncology at The Ohio State University Comprehensive Cancer Center in Columbus, Ohio.Drs. Milam and Kaffenberger are with the Division of Dermatology at The Ohio State University Wexner Medical Center in Columbus, Ohio. Drs. Berger, Ramaswamy, Reinbolt, and Weslowski are with the Division of Medical Oncology at The Ohio State University Comprehensive Cancer Center in Columbus, Ohio.Drs. Milam and Kaffenberger are with the Division of Dermatology at The Ohio State University Wexner Medical Center in Columbus, Ohio. Drs. Berger, Ramaswamy, Reinbolt, and Weslowski are with the Division of Medical Oncology at The Ohio State University Comprehensive Cancer Center in Columbus, Ohio.Drs. Milam and Kaffenberger are with the Division of Dermatology at The Ohio State University Wexner Medical Center in Columbus, Ohio. Drs. Berger, Ramaswamy, Reinbolt, and Weslowski are with the Division of Medical Oncology at The Ohio State University Comprehensive Cancer Center in Columbus, Ohio.Drs. Milam and Kaffenberger are with the Division of Dermatology at The Ohio State University Wexner Medical Center in Columbus, Ohio. Drs. Berger, Ramaswamy, Reinbolt, and Weslowski are with the Division of Medical Oncology at The Ohio State University Comprehensive Cancer Center in Columbus, Ohio.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

31531159

Citation

Milam, Philip, et al. "Spider Telangiectases and Palmar Erythema as Harbingers of Structural Liver Changes in Three Breast Cancer Patients On Ado-trastuzumab Emtansine." The Journal of Clinical and Aesthetic Dermatology, vol. 12, no. 7, 2019, pp. 23-26.
Milam P, Berger M, Ramaswamy B, et al. Spider Telangiectases and Palmar Erythema as Harbingers of Structural Liver Changes in Three Breast Cancer Patients on Ado-trastuzumab Emtansine. J Clin Aesthet Dermatol. 2019;12(7):23-26.
Milam, P., Berger, M., Ramaswamy, B., Reinbolt, R., Wesolowski, R., & Kaffenberger, B. H. (2019). Spider Telangiectases and Palmar Erythema as Harbingers of Structural Liver Changes in Three Breast Cancer Patients on Ado-trastuzumab Emtansine. The Journal of Clinical and Aesthetic Dermatology, 12(7), pp. 23-26.
Milam P, et al. Spider Telangiectases and Palmar Erythema as Harbingers of Structural Liver Changes in Three Breast Cancer Patients On Ado-trastuzumab Emtansine. J Clin Aesthet Dermatol. 2019;12(7):23-26. PubMed PMID: 31531159.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spider Telangiectases and Palmar Erythema as Harbingers of Structural Liver Changes in Three Breast Cancer Patients on Ado-trastuzumab Emtansine. AU - Milam,Philip, AU - Berger,Michael, AU - Ramaswamy,Bhuvaneswari, AU - Reinbolt,Raquel, AU - Wesolowski,Robert, AU - Kaffenberger,Benjamin H, Y1 - 2019/07/01/ PY - 2019/9/19/entrez PY - 2019/9/19/pubmed PY - 2019/9/19/medline KW - Ado-trastuzumab emtansine KW - T-DM1 KW - cirrhosis KW - metastatic breast cancer KW - nodular regenerative hyperplasia KW - palmar flushing KW - pseudocirrhosis KW - telangiectasia SP - 23 EP - 26 JF - The Journal of clinical and aesthetic dermatology JO - J Clin Aesthet Dermatol VL - 12 IS - 7 N2 - Objective: We describe three patients treated with ado-trastuzumab emtansine who developed either palmar flushing or spider angiomas. We then correlate these findings with radiologic imaging results of the liver. Design: Three consecutive referrals to dermatology for patient skin complaints while taking ado-trastuzumab emtansine were evaluated and found to have either telangiectases or palmar flushing. Two patients who did not have prominent nodularity on computed tomography of the liver underwent transient elastography. Results: All three patients with stigmata of liver disease that developed during the course of ado-trastuzumab emtansine demonstrated parenchymal liver abnormalities. Conclusion: Patients presenting with spider angiomas and/or palmar flushing on adotrastuzumab emtansine should be considered for elastography studies to ensure early structural damage is not occurring. Further investigation is needed to define the precise etiology for these telangiectases and the role of elastography imaging in monitoring patients on long-term adotrastuzumab emtansine. SN - 1941-2789 UR - https://www.unboundmedicine.com/medline/citation/31531159/Spider_Telangiectases_and_Palmar_Erythema_as_Harbingers_of_Structural_Liver_Changes_in_Three_Breast_Cancer_Patients_on_Ado-trastuzumab_Emtansine L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31531159/ DB - PRIME DP - Unbound Medicine ER -