Faculty Collaboration Database

Effective use of mirtazapine for refractory pruritus associated with carcinoma en cuirasse. BMJ Support Palliat Care 2016 Mar;6(1):119-21

Date

12/18/2014

Pubmed ID

25515938

DOI

10.1136/bmjspcare-2014-000790

Scopus ID

2-s2.0-84958756182 (requires institutional sign-in at Scopus site)   18 Citations

Abstract

Pruritus is a debilitating symptom that can be associated with cutaneous involvement by an underlying malignancy. We report the case of a 68-year-old woman with a history of triple-negative breast cancer who presented with extensive, localised cutaneous metastasis complicated by incapacitating, treatment-refractory pruritus localised to the anatomic regions involved by her metastatic disease. Physical examination revealed an indurated, ecchymotic, ulcerated plaque circumferentially encasing her thorax. Histopathological examination revealed substantial dermal lymphatic involvement and dilation as well as dermal collagen infiltration by tumour cells and nodules. The clinical and pathological findings were consistent with a diagnosis of carcinoma en cuirasse. Mirtazapine, a noradrenergic antidepressant with antiserotonin and antihistamine activity, was started and led to rapid, sustained relief of the patient's pruritus. Mirtazapine may be a useful systemic agent for the palliative relief of pruritus associated with cutaneous infiltration by an underlying malignancy.

Author List

Lee JJ, Girouard SD, Carlberg VM, Mostaghimi A

Author

Valerie M. Carlberg MD Associate Professor in the Dermatology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Antidepressive Agents, Tricyclic
Antipruritics
Carcinoma, Ductal, Breast
Female
Histamine Antagonists
Humans
Mianserin
Pruritus
Serotonin Antagonists
Skin Neoplasms
Treatment Outcome
Triple Negative Breast Neoplasms