ABSTRACT
Sclerotic reactions can develop during treatment with various cancer therapies. Bleomycin-induced sclerotic reactions in the skin most commonly involve the hands and feet in an “acrosclerosis” distribution, sparing the trunk and face. Sclerotic bands on the fingers may impede function, and digital ulcerations can develop. Although features of systemic sclerosis such as telangiectasias, periungual erythema, calcinosis cutis, and autoantibodies are usually absent, pulmonary fibrosis may accompany the cutaneous sclerotic changes. Cutaneous immune-related adverse events are common with the use of immunotherapy, and such reactions may include sclerotic skin reactions. Skin biopsy revealed mild fibrosis and sclerosis with trapping of adnexal structures and minimal lymphocytic inflammation. A skin biopsy revealed lichen sclerosus with underlying morphea. Treatment for radiation-induced sclerotic skin reactions include anti-inflammatory agents such as topical, intralesional, or systemic corticosteroids; pentoxifylline; or antioxidant treatment with superoxide disumutase, tocopherol, or PTX-vitamin E combination.
