Isolated Bilateral Ear and Scalp Rash After Cytarabine Therapy for Acute Myelogenous Leukemia: A Report and Literature Review

Waseem, Husnain; Felipe, Carlos Henriquez; Hashmi, Arsalan Talib; Ansar, Maham; Batool, Asiya; Saverimuthu, Angela; Kamholz, Stephan L.

doi:10.1097/mjt.0000000000000850

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…Similarly, Ruben et al [2] revealed that the average time of clearance and desquamation is 15 days and the complete resolution was observed within 30 days. Moreover, extensive testing and/or treatment could be spared [2, 3, 8, 17]. Only symptomatic treatment with cold compression, analgesics, and oral antihistamine is required for particular cases.…”

Section: Discussionmentioning

confidence: 99%

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Bilateral Ear Swelling and Erythema after Chemotherapy: A Case Report of Ara-C Ears

Jaruvijitrattana

Chanprapaph

2019

Case Rep Dermatol

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Cytarabine is an antimetabolite commonly used to treat hematological malignancies, especially acute myeloid leukemia (AML), acute lymphoblastic leukemia, and non-Hodgkin’s lymphoma. Cytarabine-induced cutaneous adverse effects are common, usually manifesting as morbilliform eruptions predominantly on the acral site, intertriginous zone, and to a lesser extent on the elbows, knees, neck, and ears. The presentation on ears is usually called “Ara-C ears,” which is considered as a rare subtype of acral erythema. We report a 53-year-old Thai woman with AML who developed cytarabine-induced rashes. The lesions began on symmetrical bilateral ears, posterior auricular areas, and forehead followed by expansion to the trunk and extremities. The clinical presentations and histopathological findings were compatible with toxic erythema of chemotherapy. After giving cetirizine 10 mg orally twice daily and 0.1% triamcinolone acetonide cream twice daily, the lesions gradually improved over 10 days. Notably, two additional courses of high-dose cytarabine were administered without any recurrence.

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Section: Discussionmentioning

confidence: 99%

“…Only symptomatic treatment with cold compression, analgesics, and oral antihistamine is required for particular cases. Most eruptions resolve without any sequelae [9, 17].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Ear Swelling and Erythema after Chemotherapy: A Case Report of Ara-C Ears

Jaruvijitrattana

Chanprapaph

2019

Case Rep Dermatol

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“…[10][11][12][13][14][15] To the best of our knowledge, only two cases of ''Ara-C-related RES'' have been reported in the past. 16,17 To conclude, RES is a rare Ara-C-related skin toxicity and physicians should be aware of its presentation, differential diagnosis, and management. It is essential to rule out infective process especially viral illnesses while evaluating possible cases of RES.…”

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confidence: 99%

“…10 –15 To the best of our knowledge, only two cases of “Ara-C-related RES” have been reported in the past. 16,17…”

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confidence: 99%

Ara-C Related Red Ear Syndrome

2019

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Hersh and Hersh in their recent article ''Red ear syndrome: Perspectives for the otolaryngologist'' explicitly discussed about the Red ear syndrome (RES) and related otorhinological conditions. 1 Ara-C, an anticancer drug, is known to cause multiple nonhematological toxicities such as cerebellar dysfunction, conjunctivitis, skin toxicity, and liver dysfunction. 2 Skin toxicity in the form of palmoplantar-erythrodysesthesia (PPE) is well reported. Here in, we describe a dermatological manifestation similar to PPE but limited only to ears. 3 Through the following case, we would like to discuss ''RES'' from hematologist's standpoint as an important dermatological side effect.A 36-year-old female was started on induction chemotherapy (Ara-C 200 mg/m 2 /day Â 7 days and daunorubicin 60 mg/m 2 / day Â 3 days) for newly diagnosed acute myeloid leukemia (AML). On the fourth day of therapy, she started developing blanchable, discrete, nonpruritic, nonpalpable, erythematous discrete over the skin of both ears (Figure 1, panel A). There were no similar lesions in other parts of the body. She denied headache, excluding the possibility of trigeminal autonomic cephalalgias. These skin lesions gradually coalesced by the fifth day to appear as diffusely erythematous ''red ear.'' Her kidney and liver function tests were normal and blood counts suggested chemotherapy-induced myelosuppression (hemoglobin-9.1 g/dL, leukocyte count-0.8 Â 10 9 /L, and platelet count-90 Â 10 9 /L). Viral serologies for cytomegalovirus, epstein-barr virus, herpes simplex virus etc. were negative ruling out the

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