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Kaposi Sarcoma Associated with Tofacitinib Use in a Patient with Rheumatoid Arthritis
Benjamin Gallo Marin1, Mayra B C Maymone1, Fadya El Rayess2
1Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, RI.
Rhode Island Medical Journal (2013)
|July 26, 2023
Summary
Iatrogenic Kaposi sarcoma developed in a rheumatoid arthritis patient on tofacitinib therapy. Discontinuing tofacitinib and using alitretinoin gel led to lesion resolution.
Area of Science:
- Oncology
- Dermatology
- Rheumatology
Background:
- Kaposi sarcoma (KS) is a vascular malignancy linked to HHV-8.
- Iatrogenic KS is associated with immunosuppression, often seen post-organ transplantation.
- Tofacitinib is a Janus kinase inhibitor used for autoimmune conditions.
Observation:
- A 69-year-old woman with rheumatoid arthritis on tofacitinib developed KS lesions.
- Lesions presented as purple-red nodules and brown plaques on the lower extremities.
- Diagnosis was confirmed via clinicopathologic correlation.
Findings:
- Discontinuation of tofacitinib and initiation of Alitretinoin 0.1% gel were implemented.
- Kaposi sarcoma lesions showed a 50% size reduction within 4 months.
- Complete resolution of KS lesions was observed at 1 year after treatment initiation.
Implications:
- This case highlights a potential association between tofacitinib and iatrogenic Kaposi sarcoma.
- Increased awareness is crucial for early diagnosis and management of KS in patients on immunomodulators.
- The findings underscore the importance of monitoring for rare adverse events with expanding use of biologics and immunomodulators.
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