Chemotherapy-induced acral erythema in patients receiving bone marrow transplantation

Crider, M. K.

doi:10.1001/archderm.122.9.1023

Cited by 28 publications

(30 citation statements)

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“…For example, palmoplantar erythema in all of our patients was because of TEC (spontaneous resolution without treatment) rather than GVHD. Second, recognition of the distribution pattern, that is, beyond the palms and soles, [22][23][24][25][26] allows for a unifying diagnosis rather than a separate diagnosis for each site of involvement. Third, in men, the high incidence of scrotal involvement actually serves as a clue to the diagnosis of TEC, but in the past was often misdiagnosed as candidiasis despite the use of prophylactic anti-fungal medications.…”

Section: Discussionmentioning

confidence: 99%

Toxic erythema of chemotherapy following i.v. BU plus fludarabine for allogeneic PBSC transplant

Parker

Cooper

Seropian

et al. 2012

Bone Marrow Transplant

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I.v. BU plus fludarabine is an effective conditioning regimen for myeloid neoplasias with low treatment-related mortality. At standard doses, cutaneous toxicity has been reported in o5% of cases. As we observed a much higher incidence of cutaneous toxicity in patients who received predominantly pharmacokinetically based doses of BU, we performed a retrospective analysis of 61 patients who received i.v. BU plus fludarabine ( þ / À antithymocyte globulin; ATG) as a conditioning regimen before allogeneic PBSC transplant. Of the 58 evaluable patients, 33 (57%) developed cutaneous toxicity that fell within the spectrum of toxic erythema of chemotherapy (TEC). The median onset of TEC was 22 days and most patients had multiple sites of involvement, with the groin, axillae and palms/soles being the favored sites. In men, scrotal involvement, sometimes severe, was also commonly observed. Initially, allergic reactions to antibiotics, fungal infections and GVHD were also considered until the clinical presentation of TEC became well recognized. In all patients, the skin healed without specific therapy but resolution often required several weeks. This series suggests that TEC is common after BU/fludarabine þ / À ATG and it is important for transplant physicians to recognize, particularly as misdiagnosis could lead to inappropriate treatment.

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Section: Discussionmentioning

confidence: 99%

Toxic erythema of chemotherapy following i.v. BU plus fludarabine for allogeneic PBSC transplant

Parker

Cooper

Seropian

et al. 2012

Bone Marrow Transplant

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“…More than a dozen other chemotherapeutic agents have been implicated [6,7], including traditional doxorubicin, docetaxel, cisplatin, cyclophosphamide, daunorubicin, doxifluridine, etoposide, floxuridine, hydroxyurea, mercaptopurine, methotrexate, mitotane, paclitaxel, tegafur, vinorelbine, epirubicin, and gefitinib [1,6,24,25,26,27,28,29,30,31,32,33]. These agents encompass a wide range of medication classes with distinct mechanisms of action, including intercalating agents, anti-mitotics, anti-metabolites, topoisomerase inhibitors, and epidermal growth factor receptor antagonists.…”

Section: Associated Drugs and Incidencementioning

confidence: 99%

“…The diagnosis of HFS is usually made from the clinical presentation, although in some patients the differential diagnosis may also include graft-versus-host disease (GVHD), erythema multiforme, other drug reactions, cellulitis, vasculitis, erythromelalgia, septic emboli, chemotherapy-induced Raynaud’s syndrome, and acral bleomycin toxicity [25,58,69]. …”

Section: Clinical Features Of Hfsmentioning

confidence: 99%

“…2). Three histopathologic features predominate in the literature for both traditional chemotherapy-associated HFS and multi-TKI-associated HFS: dyskeratotic keratinocytes at various stages of necrosis, basal layer vacuolar degeneration, and a mild perivascular or lichenoid lymphocyte-predominant infiltrate [4,20,22,25,29,59,60,64,66,87,88]. Relatively common findings include spongiosis [22,25,59,66,87], hyperkeratosis [22,59,60,87], and parakeratosis [22,25,64] (fig.…”

Section: Histopathologymentioning

confidence: 99%

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Hand-Foot Syndrome (Hand-Foot Skin Reaction, Palmar-Plantar Erythrodysesthesia): Focus on Sorafenib and Sunitinib

Lipworth¹,

2009

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Hand-foot syndrome (HFS), also called hand-foot skin reaction, palmar-plantar erythrodysesthesia, acral erythema, and Burgdorf reaction, is a dose-limiting cutaneous toxicity of many chemotherapeutic agents. Recently, the multiple tyrosine kinase inhibitor class of novel targeted therapies, including sorafenib and sunitinib, has emerged as an important cause of HFS, with 10–28% of patients treated with sunitinib and 10–62% of patients treated with sorafenib reporting HFS. This review examines the epidemiology, clinical features, histopathology, pathogenesis models, prognostic implications, and management of HFS, with particular attention to HFS induced by sorafenib and sunitinib. The high prevalence of HFS reported by patients treated with these medications underscores the need for greater understanding of the pathogenesis and management of this syndrome.

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“…It may also become generalized and develop a papular component. Most importantly, whereas CIAE resolves without aggressive management and does not pose a threat to the patient's health, acute GVHD requires prompt intervention and may be fatal 6 . High-dose methotrexate-induced acral erythema is not a common event.…”

Section: Discussionmentioning

confidence: 99%

A Case of Methotrexate-induced Bullous Acral Erythema

2007

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Chemotherapy-induced acral erythema (CIAE) is a toxic reaction to a number of different chemotherapeutic agents, and causes symmetrical, well-demarcated, painful erythema on the palms and soles which is self-limiting. CIAE with bullous reaction in relation to methotrexate has been reported, but it is more commonly associated with cytosine arabinoside. The differential diagnosis of this condition from more serious conditions such as graft-vs-host disease or toxic epidermal necrolysis is essential.In this paper, we report the case of a 65-year-old man who developed bullous acral erythema after the administration of high-dose methotrexate for the treatment of Non-Hodgkin's lymphoma. (Ann Dermatol (Seoul) 19(4) 160～162, 2007)

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Chemotherapy-induced acral erythema in patients receiving bone marrow transplantation

Cited by 28 publications

References 0 publications

Toxic erythema of chemotherapy following i.v. BU plus fludarabine for allogeneic PBSC transplant

Toxic erythema of chemotherapy following i.v. BU plus fludarabine for allogeneic PBSC transplant

Hand-Foot Syndrome (Hand-Foot Skin Reaction, Palmar-Plantar Erythrodysesthesia): Focus on Sorafenib and Sunitinib

A Case of Methotrexate-induced Bullous Acral Erythema

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