Erythema multiforme associated with cancer radiotherapy: A single‐institution case series and literature review

Abstract

tients with malignancies, both in the isolated form and in combination with diverse anticancer drugs. However, RT is reported to cause various cutaneous adverse reactions, including acute and chronic radiation dermatitis and radiation recall reaction, which tend to be limited to the irradiated skin areas. 1 In addition, widespread mucocutaneous reactions resembling erythema multiforme (EM) can occur in association with RT, including its more severe forms, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). 2 Over 100 cases have been previously reported; however, most studies had a limited number of cases. [3][4][5][6][7][8][9][10] In addition, the definite association between RT and EM-like rash is not always clear, especially in cases with concurrent drug administration. 3 To evaluate the potential association in a larger sample, we examined the records of patients who received RT and developed EM-like mucocutaneous eruptions and were referred to a dermatologist at our institute (a tertiary cancer center) within a 10-year period. Herein we report the details of the included cases. | ME THODS | Patients and inclusion criteriaWe identified patients who developed skin rash clinically resembling EM, SJS, and TEN while receiving RT for various malignancies from 2010 to 2021.

Erythema multiforme provoked by radiotherapy

“…However, cases of disseminated erythema multiforme‐like lesions have also been rarely reported in the literature. Despite its rarity, it is an important cutaneous manifestation 1,3,4 . Moreover, considering the possibility of mistaken EM with Stevens–Johnson syndrome or toxic epidermal necrolysis, and other radiation‐related conditions such as radiodermatitis or recall phenomenon, it is so critical to properly recognize the etiology, unique phenotypic findings, and timing of the skin reaction associated with various radiation‐induced skin reactions 1 …”

“…Despite its rarity, it is an important cutaneous manifestation. 1,3,4 Moreover, considering the possibility of mistaken EM with Stevens-Johnson syndrome or toxic epidermal necrolysis, and other radiation-related conditions such as radiodermatitis or recall phenomenon, it is so critical to properly recognize the etiology, unique phenotypic findings, and timing of the skin reaction associated with various radiation-induced skin reactions. 1 In this article, we report a case of a patient who developed erythema multiforme that was provoked by radiotherapy to highlight its uniqueness.…”