Chemotherapy-induced acral erythema: desquamating lesions involving the hands and feet.
Patients receiving very high doses of chemotherapeutic drugs, particularly cytarabine (cytosine arabinoside, ara-C, Cytosar), may develop chemotherapy-induced acral erythema, a painful toxic rash of the palmar surfaces of the hands that progresses to edema, blister formation, and desquamation. In more severe cases, the feet are involved, and they show similar changes. Plastic surgeons may be consulted because of the hand involvement and the clinical resemblance, after desquamation, to a very superficial second-degree burn. In patients who have had bone marrow transplantation, this diagnosis must be distinguished from graft-versus-host reaction--a desquamating skin lesion that can affect a similar anatomical area but that is progressive and productive of serious consequences. Acral erythema appears to be self-limited and requires only supportive treatment.
Kroll
S S
SS
Section of Plastic Surgery, University of Texas, M. D. Anderson Cancer Center 77030.
Koller
C A
CA
Kaled
S
S
Dreizen
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D003561:Cytarabine / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D004890:Erythema / Q000139:chemically induced*; D005260:Female; D005533:Foot Dermatoses / Q000139:chemically induced*; D006229:Hand Dermatoses / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged
D003561:Cytarabine