Leprosy: type 1 reaction precipitated by doxorubicin and cisplatin
Keywords:
Anticancer chemotherapy, type 1 leprosy reaction, tumor necrosis factor-α.Abstract
Type 1 reaction (T1R) in leprosy is common and characterized by increased inflammation in skin lesions or nerve. Besides antileprotic therapy, T1Rs are associated with intercurrent infection, pregnancy and drugs. Also, T1Rs may be a presenting feature of leprosy. We report a case of T1R in leprosy presenting as drug reaction during cancer chemotherapy with doxorubicin and cisplatin. We propose to explain this unusual occurrence by highlighting the increased production and expression of TNF-α by these drugs. Thus, physicians using these drugs should keep this unusual adverse effect in mind.ÂReferences
Walker SL, Lockwood DN. Leprosy type 1(reversal) reactions and their management.
Lepr Rev. 2008;79:372-86.
Balagula Y, Rosen ST, Lacouture ME. The emergence of supportive oncodermatology: The study of dermatologic adverse events to cancer therapies. J Am Acad Dermatol. 2011;65:624-35.
Ridwelski. K, Gebauer T, Fahlke J et al. Combination chemotherapy with docetaxel and cisplatin for locally advanced and metastatic gastric cancer. Ann Oncol. 2001;12:47-51.
Ochoa MT, Stenger S, Sieling PA et al. T-cell release of granulysin contributes to host defense in leprosy. Nat Med. 2001;7:174-9
Kindler V, Sappino AP, Grau GE et al. The inducing role of tumour necrosis factor in the development of bactericidal granulomas during BCG infection. Cell. 1989;56:73-40.
Khanolkar-Young S, Rayment N, Brickell PM et al. Tumour necrosis factor-alpha (TNFalpha) synthesis is associated with the skin and peripheral nerve pathology of leprosy reversal reactions. Clin Exp Immunol. 1995;99:196- 202.
Barnes PF, Fong SJ, Brennan PJ et al. Local production of tumour necrosis factor and IFN- γ in tuberculous peritonitis. J Immunol. 1990;145:149-5.
Deng J, Kohda Y, Chiao H et al. Interleukin- 10 inhibits ischemic and cisplatin-induced acute renal injury. Kidney Int. 2001;60:2118- 28.