Chemotherapy-induced eccrine squamous syringometaplasia. A distinctive eruption in patients receiving hematopoietic progenitor cells.
BACKGROUND
Eccrine squamous syringometaplasia (ESS) has been associated with characteristic clinical eruption in patients receiving chemotherapy. It has been suggested as a diagnostic clue in the diagnosis of chemotherapy-induced reactions vs acute graft-vs-host disease, as well as other drug reactions. We identified 10 cases of ESS in patients in whom a distinctive clinical eruption developed during or after a pretransplantation conditioning regimen with high-dose chemotherapy. A complete clinical and histologic evaluation was performed in all patients.


METHODS
All patients developed erythematous and edematous plaques or confluent erythematous macular areas in the axillae and/or groin, with painful areas of well-defined erythema and edema on palms and/or soles in 5 patients. Some discrete papular lesions on the trunk or extremities could also be observed in most patients. The histologic hallmark of the eruption was ESS, with a variable degree of cornification and apoptosis. A vacuolar interface dermatitis and a variable degree of cellular atypica were also consistent findings.


CONCLUSIONS
Chemotherapy-induced ESS may be associated with a distinctive clinical eruption and should be considered in the differential diagnosis of erythematous eruptions during or after a pretransplantation conditioning regimen with high-dose chemotherapy.
Valks
R
R
Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain.
Fraga
J
J
Porras-Luque
J
J
Figuera
A
A
Garcia-Diéz
A
A
Fernändez-Herrera
J
J
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D017209:Apoptosis; D016026:Bone Marrow Transplantation; D003872:Dermatitis / Q000209:etiology / Q000473:pathology; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology*; D004439:Eccrine Glands / Q000187:drug effects / Q000473:pathology*; D004487:Edema / Q000139:chemically induced / Q000473:pathology; D004848:Epithelium / Q000187:drug effects / Q000473:pathology; D004890:Erythema / Q000139:chemically induced / Q000473:pathology; D005260:Female; D005533:Foot Dermatoses / Q000139:chemically induced / Q000473:pathology; D006086:Graft vs Host Disease / Q000175:diagnosis; D006229:Hand Dermatoses / Q000139:chemically induced / Q000473:pathology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D013543:Sweat Gland Diseases / Q000139:chemically induced / Q000473:pathology; D014617:Vacuoles / Q000648:ultrastructure