title: Cytosine arabinoside-induced vasculitis.
abstract: Dermatologic side effects of cytosine arabinoside (ara-C) are rare and most commonly occur after high-dose (more than 100 to 200 mg/m2 per day) therapy has been administered for several days. Although vascular reactions after combination chemotherapeutic regimens with ara-C have been anecdotally described, they have not been previously reported after single-agent chemotherapy with ara-C. Herein we describe two patients with acute nonlymphoblastic leukemia in whom cutaneous small vessel necrotizing vasculitis developed after high-dose single-agent chemotherapy with ara-C. Cutaneous lesions developed 3 to 5 days after initiation of therapy and resolved spontaneously within a week after the chemotherapeutic regimen was completed. No evidence of systemic vasculitis was present in either patient. Prior experimental data have demonstrated a direct toxic effect of ara-C on endothelial cells, and this outcome may represent the underlying mechanism of vascular injury.
authors.affiliation: Department of Dermatology, Mayo Clinic Rochester, Minnesota, USA.
authors.forename: I
authors.initials: I
authors.lastname: Ahmed
authors.forename: K R
authors.initials: KR
authors.lastname: Chen
authors.forename: H
authors.initials: H
authors.lastname: Nakayama
authors.forename: L E
authors.initials: LE
authors.lastname: Gibson
mesh_terms: D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D003561:Cytarabine / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy; D014657:Vasculitis / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine