title: Host-vs.-altered-host eruptions in patients on liposomal doxorubicin.
abstract: BACKGROUND
  Anthracycline antitumor antibiotics are the most commonly used chemotherapeutic agents. One of these is doxorubicin. Liposomal doxorubicin was developed as a drug delivery system in order to deliver the active drug intracellularly while decreasing the systemic toxicity, particularly hematological and cardiac toxicity.
  
  
  METHODS
  The clinical and histologic findings of the cutaneous eruptions of associated with liposomal doxorubicin are reviewed.
  
  
  RESULTS
  The eruptions occurred in three women with metastatic ovarian carcinoma who were treated with liposomal doxorubicin. These three patients developed erythematous macular/papular to plaque cutaneous lesions, and in one patient a vesicular component. The eruptions involved the trunk and extremities approximately 3-4 weeks after completions of therapy. None of the patients had any documented infections, and none of the patients had symptoms other than pruritus. The eruptions cleared over a period of weeks to months. Histologic features included an interface dermatitis with numerous apoptotic/dyskeratotic cells within the epidermis, with involvement the intra-epidermal sweat ducts and the infundibulum of hair follicles.
  
  
  CONCLUSIONS
  We believe that these eruptions represented a chemotherapy induced host-vs.-altered host reaction.
authors.affiliation: Laboratory Corporation of America, Herndon, Virginia, USA.
authors.forename: Henry
authors.initials: H
authors.lastname: Skelton
authors.forename: Jill
authors.initials: J
authors.lastname: Linstrum
authors.forename: Kathleen
authors.initials: K
authors.lastname: Smith
mesh_terms: D000052:Acanthosis Nigricans / Q000209:etiology / Q000473:pathology; D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D017209:Apoptosis / Q000187:drug effects; D002277:Carcinoma / Q000150:complications / Q000188:drug therapy / Q000556:secondary; D003602:Cytotoxicity, Immunologic / Q000276:immunology*; D004317:Doxorubicin / Q000009:adverse effects*; D003875:Drug Eruptions / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D004890:Erythema / Q000209:etiology / Q000473:pathology; D005260:Female; D005447:Fluocinonide / Q000627:therapeutic use; D005938:Glucocorticoids; D006801:Humans; D007642:Keratosis / Q000209:etiology / Q000473:pathology; D008081:Liposomes; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D005938:Glucocorticoids; D008081:Liposomes; D005447:Fluocinonide; D004317:Doxorubicin