Toxic erythema of chemotherapy following leukemia cutis

J La State Med Soc. 2014 Nov-Dec;166(6):236-8. Epub 2014 Dec 15.

Abstract

A 56-year-old Caucasian male newly diagnosed with acute myelogenous leukemia (AML) M3 presented with a six-week history of multiple painful erythematous nodules scattered on his trunk and extremities, previously treated as abscesses with incision and drainage plus oral trimethoprim-sulfamethoxazole without improvement. A punch biopsy was performed, and the histopathology and immunostaining profile were compatible with leukemia cutis secondary to AML. Induction chemotherapy for AML with cytarabine, etoposide, and mitoxantrone was initiated. Dermatology was reconsulted two weeks later for evaluation and treatment of a new eruption on both dorsal hands and wrists that began three days after starting induction chemotherapy. On physical exam, there were well-demarcated erythematous patches and plaques with mild induration on the hands, extending onto the distal forearms and sparing the dorsal metacarpalphalangeal joints and ventral wrists. Biopsy findings were consistent with toxic erythema of chemotherapy, likely secondary to cytarabine.

Publication types

  • Case Reports

MeSH terms

  • Antimetabolites, Antineoplastic / adverse effects
  • Antimetabolites, Antineoplastic / therapeutic use
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Agents, Phytogenic / adverse effects
  • Antineoplastic Agents, Phytogenic / therapeutic use
  • Cytarabine / adverse effects*
  • Cytarabine / therapeutic use
  • Erythema / chemically induced
  • Erythema / diagnosis*
  • Erythema / drug therapy
  • Etoposide / adverse effects
  • Etoposide / therapeutic use
  • Humans
  • Induction Chemotherapy / adverse effects*
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / drug therapy
  • Male
  • Middle Aged
  • Mitoxantrone / adverse effects
  • Mitoxantrone / therapeutic use
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / etiology
  • Treatment Outcome

Substances

  • Antimetabolites, Antineoplastic
  • Antineoplastic Agents
  • Antineoplastic Agents, Phytogenic
  • Cytarabine
  • Etoposide
  • Mitoxantrone