Tamoxifen-induced radiation recall dermatitis.

Area of Science:

• Dermatology
• Oncology
• Pharmacology

Background:

• Radiation recall dermatitis (RRD) is an uncommon adverse reaction to prior radiation therapy, typically manifesting weeks to years post-exposure.
• Chemotherapy agents are the most frequent triggers for RRD, with tamoxifen-induced cases being exceptionally rare.

Observation:

• A case report details an adult woman with a history of inflammatory breast cancer who developed RRD after over four years of tamoxifen therapy.
• The patient presented with an erythematous, scaly, and tender plaque on previously irradiated skin, localized to the left chest.

Findings:

• Diagnosis of RRD was confirmed via biopsy, showing changes consistent with radiation dermatitis and ruling out malignancy.
• Treatment with topical triamcinolone 0.1% cream resulted in rapid improvement of symptoms despite the continuation of tamoxifen therapy.

Implications:

• Tamoxifen-induced RRD, though rare, can occur significantly later than typically observed, posing a diagnostic challenge.
• Clinicians must be aware of RRD's varied presentation to avoid misdiagnosis as infection or malignancy, ensuring prompt and appropriate patient management.