Scrotal ulceration during all-trans retinoic (ATRA) therapy for acute promyelocytic leukaemia.
We report the development of painful scrotal ulceration in two patients during treatment with all-trans-retinoic acid (ATRA) for acute promyelocytic leukaemia (APL). ATRA 45 mg/m2 was administered orally for 8 days prior to the addition of standard induction chemotherapy. Painful scrotal ulceration developed in both cases within 2 weeks of therapy (9 and 13 days) and responded slowly to drug withdrawal and systemic, or topical, corticosteroids. A total of 17 APL patients have been treated with ATRA at our institution during the last 10 years, giving an incidence of approximately 12%. The present report, together with a review of literature, suggests that scrotal ulceration is a specific adverse effect of ATRA therapy and that this complication may be more common than previously documented.
Department of Haematology, Royal Hallamshire Hospital, Sheffield, UK.
K S
KS
Charles
M
M
Kanaa
D A
DA
Winfield
J T
JT
Reilly
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D005832:Genital Diseases, Male / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012611:Scrotum / Q000473:pathology*; D014212:Tretinoin / Q000008:administration & dosage / Q000009:adverse effects*; D014456:Ulcer / Q000139:chemically induced* / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D014212:Tretinoin