Tamoxifen-induced radiation recall dermatitis

Abstract

Background: Radiation recall dermatitis (RRD) can present days to years after radiation exposure and is most commonly caused by chemotherapy drugs, with tamoxifen-induced radiation recall dermatitis being exceptionally rare. Purpose: To report a new case of tamoxifen-induced radiation recall dermatitis after 4.5 years of tamoxifen exposure, making this the longest time of onset to RRD after tamoxifen initiation. Materials and Methods: The case of a woman with tamoxifen-induced RRD is presented. Using PubMed and Google Scholar, the terms tamoxifen, radiation, recall, dermatitis were searched. Relevant citations were utilized and discussed. Results: An adult woman with history of inflammatory breast carcinoma developed an erythematous, scaly, tender plaque localized to previously irradiated skin of the left chest after more than four years of tamoxifen therapy. The patient was diagnosed with RRD and was treated with topical triamcinolone 0.1% cream twice daily to the affected areas. The patient experienced subsequent rapid improvement despite continuation of tamoxifen treatment. Biopsy revealed changes consistent with radiation dermatitis with no evidence of malignancy. Conclusion: Radiation recall dermatitis can have significant impact on affected patients and can pose a diagnostic dilemma for clinicians who may mistake RRD for infection or recurrence of malignancy. It is important to be familiar with the presenting signs and symptoms of this entity so that affected patients can receive timely and appropriate therapy.