[Scleroderma-like skin changes following administration of paclitaxel for the treatment of ovarian carcinoma]

A 61-year-old women with ovarian carcinoma was treated with surgery followed by 6 cycles of paclitaxel (Taxol) and carboplatin, producing a complete remission. During the course of therapy, she developed diffuse cutaneous sclerosis and thickening along with edema, weight gain and malaise. While antinuclear antibodies were elevated, specific antibodies against Scl 70 were not found. Other routine laboratory investigations were normal or negative. 20 MHz sonography showed a thickened, echo-rich dermis, while the Cutometer documented decreased cutaneous elasticity. Esophageal manometry identified abnormal motility. Additional screening and imaging studies showed no further evidence of systemic involvement. A skin biopsy showed dermal sclerosis. Treatment with immunosuppressive agents - prednisolone, azathioprine, cyclophosphamide- and phototherapy, including both UVA-1 and PUVA combined with penicillin, produced no definite improvement. One year after the administration of paclitaxel, the sclerosis and malaise are only minimal improved. This case is the second documented association of scleroderma-like cutaneous changes with paclitaxel therapy. Similar cases have been more often described following treatment with the analog substance docetaxel (Taxotere).