{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T17:59:20Z","timestamp":1759341560243},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,5,22]],"date-time":"2012-05-22T00:00:00Z","timestamp":1337644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:p>Gemcitabine is a deoxycytidine analog antimetabolite that is now accepted as first\u2010line treatment for advanced and metastatic pancreatic carcinoma. Gemcitabine\u2010related thrombotic microangiopathy associated with systemic hemolytic\u2010uremic syndrome or thrombotic thrombocytopenia purpura has rarely been described. Herein, we report a patient who developed a livedoid thrombotic microangiopathy with no signs of associated hemolytic\u2010uremic syndrome. Cutaneous thrombotic microangiopathy occurred after the administration of his 17th cycle and a cumulative dose of 53.65 g\/m<jats:sup>2<\/jats:sup> of gemcitabine. Some authors have suggested that this toxicity may be dose\u2010related, and a 10th cycle or a cumulative dose of 9\u201356 g\/m<jats:sup>2<\/jats:sup> have been proposed as the prothrombotic threshold. Interestingly, dermatopathologic findings were limited to the subcutis and they consisted of small\u2010vessel occlusion by intravascular fibrin and leukocytes, vessel wall thickening and endothelial cell swelling. Surprisingly, we observed some structures arranged radially with needle\u2010shaped clefts resembling those of sclerema neonatorum. Awareness of this potential cutaneous toxicity by dermatologists and dermatopathologists is extremely important.<\/jats:p><jats:p>Mir\u2010Bonaf\u00e9 JM, Rom\u00e1n\u2010Curto C, Santos\u2010Briz A, Ca\u00f1ueto J, Fern\u00e1ndez\u2010L\u00f3pez E, Unamuno P. Gemcitabine\u2010associated livedoid thrombotic microangiopathy with associated sclerema neonatorum\u2010like microscopic changes.<\/jats:p>","DOI":"10.1111\/j.1600-0560.2012.01918.x","type":"journal-article","created":{"date-parts":[[2012,5,22]],"date-time":"2012-05-22T10:46:42Z","timestamp":1337683602000},"page":"707-711","source":"Crossref","is-referenced-by-count":10,"title":["Gemcitabine\u2010associated livedoid thrombotic microangiopathy with associated sclerema neonatorum\u2010like microscopic changes"],"prefix":"10.1111","volume":"39","author":[{"given":"Jos\u00e9 M.","family":"Mir\u2010Bonaf\u00e9","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Concepci\u00f3n","family":"Rom\u00e1n\u2010Curto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1ngel","family":"Santos\u2010Briz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Ca\u00f1ueto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilia","family":"Fern\u00e1ndez\u2010L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Unamuno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,5,22]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2009.236"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20290"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2010.491088"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1517\/14740330802374262"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdh397"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2009.07.004"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2008.03014.x"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2354.2008.01057.x"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2006.01535.x"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2001.07.001"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1345\/aph.10268"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-7310(08)74756-2"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2009.03732.x"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.114735"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2008.33"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-010-1561-8"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000372-198708000-00007"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/ j.jaad.2011.06.024]"},{"key":"e_1_2_5_20_2","unstructured":"ShahMM SaifMW.Pancreatic cancer and thrombosis.Highlights from the \u201c2010 ASCO Annual Meeting\u201d. 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