ABSTRACT
A 25-year-old female patient presented with itchy rashes on her feet for 10 years.Skin examination showed dark red plaques with clear boundaries,whose surfaces were covered with grey-brown scales,on the dorsum of toes and adjacent dorsum of the feet,the extensor aspect of the right ankle and the left Achilles tendon.Laboratory tests revealed that serum anti-hepatitis C virus (HCV) antibody was negative and HCV-RNA quantity was normal.Histopathological examination showed epidermal hyperkeratosis with parakeratosis,irregularly thickened spinous layer,scattered dyskeratotic cells and necrotic keratinocytes in the middle and upper spinous layer,focal liquefaction degeneration of basal cells,dilatation of small blood vessels in the superficial andmiddle dermis,and perivascular infiltration of a small number of lymphocytes.The patient was diagnosed with necrolytic acral erythema without hepatitis C.After 2-month treatment,the skin lesions completely regressed,and hyperpigmentation remained.
ABSTRACT
A 25-year-old female patient presented with itchy rashes on her feet for 10 years. Skin examination showed dark red plaques with clear boundaries, whose surfaces were covered with grey-brown scales, on the dorsum of toes and adjacent dorsum of the feet, the extensor aspect of the right ankle and the left Achilles tendon. Laboratory tests revealed that serum anti-hepatitis C virus (HCV) antibody was negative and HCV-RNA quantity was normal. Histopathological examination showed epidermal hyperkeratosis with parakeratosis, irregularly thickened spinous layer, scattered dyskeratotic cells and necrotic keratinocytes in the middle and upper spinous layer, focal liquefaction degeneration of basal cells, dilatation of small blood vessels in the superficial and middle dermis, and perivascular infiltration of a small number of lymphocytes. The patient was diagnosed with necrolytic acral erythema without hepatitis C. After 2-month treatment, the skin lesions completely regressed, and hyperpigmentation remained.
ABSTRACT
A 55-year-old woman on treatment with capecitabine and paclitaxel for breast carcinoma presented with history of a tingling sensation in her hands and feet with a progressive burning sensation. She also noted discomfort, minimal pain and stiffness while holding objects. On examination, there was patchy hyperpigmentation of both the palms and soles, and the dorsa of hands and feet. This was accompanied by a thickening of the skin more over the knuckles and toes. In addition there was a moist desquamation around the toes and over the palmar creases and a bluish discoloration of the lunulae of both thumbnails. She was diagnosed with hand and foot syndrome and started on pyridoxine and emollients. The finding of keratoderma noted in our patient is not seen commonly in hand and foot syndrome.
Subject(s)
Antimetabolites, Antineoplastic/adverse effects , Deoxycytidine/adverse effects , Deoxycytidine/analogs & derivatives , Female , Fluorouracil/adverse effects , Fluorouracil/analogs & derivatives , Foot , Hand , Humans , Hyperpigmentation/chemically induced , Keratoderma, Palmoplantar/chemically induced , Middle Aged , Paresthesia/chemically induced , SyndromeABSTRACT
Chemotherapy-induced acral erythema (CIAE) is an uncommon, self-limited local skin reaction that usually occurs after high-dose chemotherapy. There is no specific treatment for this disease and it disappears within three to five weeks. In this case report, we present a 16-year-old female with acute lymphoblastic leukemia who developed severe CIAE. The lesions appeared as a well-defined erythema of the hands, feet, and back with symmetrically well-defined borders 5 days after low-dose MTX treatment. The erythema progressed to bullae formation and desquamation. It resolved spontaneously within 2 weeks. CIAE is very uncommon in children; however we should consider acral erythema as a differential diagnosis when bullous skin reaction occurs in a patient who receives chemotherapy.
Subject(s)
Adolescent , Child , Female , Humans , Diagnosis, Differential , Drug Therapy , Erythema , Foot , Hand , Hand-Foot Syndrome , Methotrexate , Precursor Cell Lymphoblastic Leukemia-Lymphoma , SkinABSTRACT
Chemotherapy-induced acral erythema (CIAE) is an uncommon, self-limited local skin reaction that usually occurs after high-dose chemotherapy. There is no specific treatment for this disease and it disappears within three to five weeks. In this case report, we present a 16-year-old female with acute lymphoblastic leukemia who developed severe CIAE. The lesions appeared as a well-defined erythema of the hands, feet, and back with symmetrically well-defined borders 5 days after low-dose MTX treatment. The erythema progressed to bullae formation and desquamation. It resolved spontaneously within 2 weeks. CIAE is very uncommon in children; however we should consider acral erythema as a differential diagnosis when bullous skin reaction occurs in a patient who receives chemotherapy.
Subject(s)
Adolescent , Child , Female , Humans , Diagnosis, Differential , Drug Therapy , Erythema , Foot , Hand , Hand-Foot Syndrome , Methotrexate , Precursor Cell Lymphoblastic Leukemia-Lymphoma , SkinABSTRACT
Sorafenib (Nexavar(R), BAY 43-9006) is a new oral multi-targeted tyrosine kinase inhibitor developed to delay disease progression in advanced solid organ malignancies and metastatic melanoma. Among the many reported toxicities attributed to sorafenib, dermatologic events, such as skin rash, acral erythema, alopecia and xerosis are the most frequently observed side effects. Recently, we experienced a case of a 41-year-old man who presented with generalized maculopapular erythematous eruptions, and acral erythema after sorafenib treatment for his metastatic hepatocellular carcinoma. Herein, we report the case and discuss the undesirable side effects of sorafenib.
Subject(s)
Adult , Humans , Alopecia , Bays , Carcinoma, Hepatocellular , Disease Progression , Erythema , Exanthema , Melanoma , Niacinamide , Phenylurea Compounds , Protein-Tyrosine KinasesABSTRACT
Etoposide is a semi-synthetic podophyllotoxin that binds to microtubular proteins to inhibit cell division. It has been used extensively in the treatment of both solid and hematologic malignancies. Chemotherapy-induced acral erythema is a distinctive syndrome of painful, symmetric, well-defined swelling and erythema of the palms and soles seen in patients receiving high-dose chemotherapy. It occurs most commonly with fluorouracil, doxorubicin, and especially cytosine arabinoside. Although etoposide, mercaptopurine and methotrexate have also been implicated. Here we report a case of acral erythema induced by etoposide in a 15-year-old child with neuroblastoma.
Subject(s)
Adolescent , Child , Humans , Mercaptopurine , Cell Division , Cytarabine , Doxorubicin , Erythema , Etoposide , Fluorouracil , Hand-Foot Syndrome , Hematologic Neoplasms , Methotrexate , Podophyllotoxin , ProteinsABSTRACT
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.
Subject(s)
Aged , Humans , Cytarabine , Diagnosis, Differential , Erythema , Graft vs Host Disease , Hand-Foot Syndrome , Lymphoma, Non-Hodgkin , Methotrexate , Stevens-Johnson SyndromeABSTRACT
Chemotherapy-induced acral erythema ia a rare cutaneous reaction to high dose chemotherapy, clinically presenting with painful erythema on the palms and soles. Docetaxel-induced acral erythema is unique in that it usually occurrs on atypical sites, the dorsum of hands and peri-maleolar area. Recently, we experienced three patients with internal malignancy such as lung or ovary cancer who developed painful erythematous to violaceous patches of the dorsum of both hands and feet. The erythema began to develop 2~3 days after the 3rd~5th schedule of docetaxel chemotherapy and evolved to blister and desquamated over time. They didnt intake no other suspicious drug to induce cutaneous reactions and there was no symptom of herpes infection. Histopathological examination commonly revealed epidermal dysmaturation, vacuolar degeneration of basal layer, scattered necrotic keratinocytes and lymphohistiocytic infiltration in the upper dermis. Based on the recent medical history of docetaxel intravenous injection, the characteristic clinical features and histological findings, our three cases were all diagnosed with docetaxel-induced acral erythema. The skin lesion resolved with residual brownish discoloration after 2 weeks treatment with topical steroid.