DOCETAXEL (TAXOTERE) ASSOCIATED SCLERODERMA-LIKE CHANGES OF THE LOWER-EXTREMITIES - A REPORT OF 3 CASES

Background. Docetaxel (Taxotere) is a microtubul-estabilizing agent th at is potentially important in chemotherapy for a variety of malignanc ies. Methods. A clinical study of the cutaneous reactions experienced by a group of patients receiving docetaxel chemotherapy was undertaken . Patients were examined before initiation of therapy, before and afte r each cycle of therapy, and were followed subsequent to the completio n of docetaxel chemotherapy. Results. Three patients developed diffuse lower extremity edema (3-18 kg) and subsequent scleroderma-like chang es after receiving multiple cycles of docetaxel therapy. These patient s had different underlying malignancies and dissimilar prior therapy. Rheumatoid factor, antinuclear antibodies, anticentromere, and topoiso merase antibodies were not present in any patient. The diffuse lower e xtremity edema did not resolve with diuretic therapy. Cutaneous biopsi es in two patients revealed diffuse sclerosis. One patient had a norma l lymphangiogram during the edematous phase. Discontinuation of doceta xel correlated with resolution of edema and softening of the skin. Con clusion. The etiology of the scleroderma-like skin changes is unclear but appears to be either a toxic effect of docetaxel or an effect of p olysorbate 80 (Tween 80), the vehicle for docetaxel.