Acral Erythema with Oral Methotrexate in a Child

Varela, Carly R.; McNamara, Joseph E.; Antaya, Richard J.

doi:10.1111/j.1525-1470.2007.00513.x

Cited by 14 publications

(13 citation statements)

References 36 publications

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“…Lesions healed within 48 hours without treatment, but recurred many times. This finding may be associated with primary disease in our patients, in contrast to the cases reported in the literature, which were related to high-dose methotrexate [6,7]. Allergic drug reactions were neither as frequent as expected, nor as serious.…”

Section: Discussioncontrasting

confidence: 55%

Dermatological Findings in Turkish Paediatric Haematology-Oncology Patients

Ukşal

Öztürk²,

Çölgeçen

et al. 2016

Eurasian J Med

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Objective: Diagnoses of skin, mucosae, hair and nail manifestations in malignant diseases are often challenging because of life-threatening drug reactions, opportunistic infections or skin involvement of primary processes. Description of morphology, configuration and distribution of lesions is important in order to differentiate the self-healing eruptions from serious side effects of chemotherapy. There are case reports from Turkey including dermatological manifestations of malignancies and case series in adult patients but there are no published large group studies assessing all manifestations in children. The aim of this study was to evaluate the morphological features of dermatological findings in children with haemato-oncological diseases. Materials and Methods: The study was performed at the Erciyes University, Faculty of Medicine Pediatric Hematology-Oncology Clinic, Turkey. Three dermatologists daily consulted all patients admitted to the clinic during a one-year period. Results: The study group comprised of 157 children (79 female/78 male) aged 1-16 years (mean 7.19±4.63). Detailed dermatological examinations were performed, including oral-genital mucosae, hair and nails. Thorough skin examination revealed that 70% of the patients exhibited at least one dermatological finding. Generalized xerosis and hyperpigmentation were the most common findings among patients undergoing chemotherapy (24.19%). Multiple nevi on at least 10 covered areas were very frequent among patients undergoing long-term chemotherapy (18.47%). Three were identified as dysplastic nevus, but malignant transformation was not observed during the one-year study period. Conclusion: Regular dermatological consultation may help resolve the diagnostic and therapeutic problems in paediatric haemato-oncology clinics.

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Section: Discussioncontrasting

confidence: 55%

Dermatological Findings in Turkish Paediatric Haematology-Oncology Patients

Ukşal

Öztürk²,

Çölgeçen

et al. 2016

Eurasian J Med

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“…More recently, numerous cases of bullous acral erythema have been reported in response to intravenous methotrexate, particularly in children 11–17 . Additionally, there has been one recent report of bullous acral erythema occurring with oral methotrexate 18 . In total, 11 cases of bullous acral erythema have been reported with the use of methotrexate (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Bullous acral erythema: an additional consideration in the differential diagnosis of pauci‐inflammatory subepidermal bullae^*

Podjasek

Camilleri

2012

J Cutan Pathol

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Acral erythema is considered a frequent complication of chemotherapy administration. The bullous variant of chemotherapy-induced acral erythema, or bullous acral erythema, occurs less commonly. The condition typically begins with acral dysesthesias and produces symmetric erythema that blisters and eventually desquamates. Overall, 32 cases of bullous acral erythema have been described in the literature, including 21 cases associated with cytarabine administration and 11 cases attributed to methotrexate. We describe a 61-year-old woman with diffuse large B-cell lymphoma in whom bullous acral erythema developed after she received cytarabine and methotrexate. The clinical presentation was unusual, as it was characterized by vesicles in an annular configuration suggestive of linear immunoglobulin A bullous disease. Histopathology revealed a pauci-inflammatory subepidermal bulla that was similar to previously reported cases of bullous acral erythema. We suggest that bullous acral erythema represents an important diagnostic consideration in the differential diagnosis of pauci-inflammatory subepidermal blistering in patients who have recently received chemotherapy.

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“…It is has been used successfully for over 50 years for a wide variety of cutaneous diseases4. This drug is approved for treatment of moderate to severe psoriasis, and cutaneous T cell lymphoma, and it has been known to be effective in many other dermatoses, including atopic dermatitis, vascular disease, and blistering disease5-7.…”

Section: Discussionmentioning

confidence: 99%

“…This drug is approved for treatment of moderate to severe psoriasis, and cutaneous T cell lymphoma, and it has been known to be effective in many other dermatoses, including atopic dermatitis, vascular disease, and blistering disease5-7. Rapidly proliferating cells are susceptible to MTX because most cells are in the S-phase, where this drug exerts its effects1,4. Gastrointestinal mucosa, hair, and bone marrow are very susceptible to MTX because of the high rate of cellular turnover3.…”

Section: Discussionmentioning

confidence: 99%

“…This drug may cause various mucocutaneous adverse reactions, including mucositis, bone marrow depression, hepatitis, and renal insufficiency3,4. Although development of skin ulceration in a small number of patients has been reported5-7, multifocal mucocutaneous involvement, which shows similar clinical features with Behçet's disease has not been reported.…”

Section: Introductionmentioning

confidence: 99%

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A Case of Cutaneous Side Effect of Methotrexate Mimicking Behçet's Disease

et al. 2011

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Methotrexate (MTX) is an antimetabolite which interferes with DNA synthesis, and it is used for the treatment of moderate to severe psoriasis, atopic dermatitis and a wide variety of cutaneous diseases. Although many adverse effects of MTX, including cutaneous ulcerations, have been documented, multifocal mucosal ulceration mimicking Behçet's disease has not been reported. In our case, a 63-year-old female presented with oral, vaginal ulcer and multiple purpuric patches on both legs. Considering patient's clinical course and histopathologic findings, we presumed that these reactions may be the side effect of MTX administered for treatment of necrotizing scleritis. Herein we report the cutaneous side effect of MTX that manifested clinically like Behçet's disease.

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Acral Erythema with Oral Methotrexate in a Child

Cited by 14 publications

References 36 publications

Dermatological Findings in Turkish Paediatric Haematology-Oncology Patients

Dermatological Findings in Turkish Paediatric Haematology-Oncology Patients

Bullous acral erythema: an additional consideration in the differential diagnosis of pauci‐inflammatory subepidermal bullae^*

A Case of Cutaneous Side Effect of Methotrexate Mimicking Behçet's Disease

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Acral Erythema with Oral Methotrexate in a Child

Cited by 14 publications

References 36 publications

Dermatological Findings in Turkish Paediatric Haematology-Oncology Patients

Dermatological Findings in Turkish Paediatric Haematology-Oncology Patients

Bullous acral erythema: an additional consideration in the differential diagnosis of pauci‐inflammatory subepidermal bullae*

A Case of Cutaneous Side Effect of Methotrexate Mimicking Behçet's Disease

Contact Info

Product

Resources

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Bullous acral erythema: an additional consideration in the differential diagnosis of pauci‐inflammatory subepidermal bullae^*