The skin: an immunoreactive target organ during interleukin-2 administration?
Six patients with metastatic malignant melanoma were treated systemically with dacarbazine and interleukin-2 (IL-2). During IL-2 administration all patients developed a macular erythematous rash followed by scaling which began 24-48 h after IL-2 infusion. The dermatological changes were associated with elevated interferon-gamma and tumor necrosis factor alpha serum levels (immunoradiometric assay). Histology revealed nonspecific spongiotic foci in the epidermis and a perivascular mononuclear infiltrate in the dermis. Immunohistochemistry characterized this infiltrate mainly as activated T helper lymphocytes and revealed the expression of intercellular adhesion molecule 1 by endothelial cells and keratinocytes that might have been induced by interferon-gamma. The skin reactions associated with systemic IL-2 administration, show that the skin actually participates as a target organ. They should be differentiated from drug eruptions.
Dummer
R
R
Department of Dermatology, University of Würzburg Medical School, FRG.
Miller
K
K
Eilles
C
C
Burg
G
G
D001706:Biopsy; D003131:Combined Modality Therapy; D016207:Cytokines / Q000097:blood; D003606:Dacarbazine / Q000008:administration & dosage / Q000627:therapeutic use*; D003872:Dermatitis / Q000097:blood / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D015592:Immunoradiometric Assay; D007371:Interferon-gamma / Q000097:blood; D007376:Interleukin-2 / Q000008:administration & dosage / Q000009:adverse effects*; D008545:Melanoma / Q000628:therapy*; D012878:Skin Neoplasms / Q000628:therapy*; D016176:T-Lymphocyte Subsets / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D016207:Cytokines; D007376:Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D003606:Dacarbazine; D007371:Interferon-gamma