Mucocutaneous complications of chemotherapy in 74 patients from Maharaj Nakorn Chiang Mai Hospital.

BACKGROUND: There have been many reports about mucocutaneous complications of chemotherapy from western countries, but they are only small case series. Until now, there had been no such report in Thailand. OBJECTIVE: We assessed mucocutaneous complications in patients who received chemotherapy. PATIENTS AND METHOD: A total of 74 patients, admitted for chemotherapy from October 2001 to January 2002 in the Internal Medicine Department, Maharaj Nakhon Chiang Mai Hospital, were studied. RESULTS: Of 74 patients (53 male and 21 female), we found a statistically significant relation between gemcitabine and alopecia (p = .020), bleomycin and hyperpigmentation (p = .030), and cytarabine and ichthyosis (< .001). The most common findings were alopecia (76.68%), hyperpigmentation (31.08%), transverse white bands of the nails (22.97%), and ichthyosis (20.27%). Other notable findings included oral mucositis, acne, acral erythema, flushing, onycholysis, urticaria, pruritus, phlebitis and cutaneous infections (including tinea corporis, tinea ungium, and warts). CONCLUSION: Mucocutaneous complications are common in patients who have received chemotherapy. However, a further study with a larger sample size and specified chemotherapy regimen would be valuable.

Entomophthoromycosis in Maharaj Nakorn Chiang Mai Hospital.

OBJECTIVE: To review documented entomophthoromycosis patients at Maharaj Nakorn Chiang Mai Hospital from 1985 to 2001. MATERIAL AND METHOD: A retrospective review was performed at Maharaj Nakorn Chiang Mai Hospital from 1985 to 2001. Eight cases of entomophthoromycosis were found between 1988 and 1993, with five patients diagnosed as subcutaneous zygomycosis, I GI entomophthoromycosis and 2 rhinofacial zygomycosis. RESULTS: The subcutaneous zygomycosis group was composed of 5 female patients, aged 7- 77 years. They presented with a painless subcutaneous mass, which was solitary or multiple and most commonly found on the extremities. The duration of disease was between 3 months to 5 years. The cultures grew Basidiobolus ranarum. A case of GI entomophthoromycosis was seen in a 34 year old man, who presented with dyspepsia, multiple intraabodminal masses and peritonitis. Two cases of conidiobolomycosis (rhinofacial zygomycosis) were seen. These two patients were male, 26 and 39 years old, and they presented with unilateral nasal obstruction from a mass at the inferior turbinate. The cultures grew Conidiobolus coronatus. CONCLUSION: Entomophthoromycosis in the northern part of Thailand is rare. The disease should be differentially diagnosed by a chronic painless tumor. The patients in this review responded very well to the recommended therapy.

Acquired reactive perforating collagenosis: report of a case and review of the literature.

A case of acquired reactive perforating collagenosis is reported in a 57-year-old Thai woman, with a history of diabetes mellitus, chronic renal insufficiency needing hemodialysis, and dry gangrene of the right fourth toe. Physical examination revealed multiple scattered erythematous hyperkeratotic nodules and plaques and some showed ulceration. Histopathology showed vertical strands of collagen perforating from the ulcerated lesions. The authors also reviewed the literature on this subject.