Host-vs.-altered-host eruptions in patients on liposomal doxorubicin.
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.
Skelton
Henry
H
Laboratory Corporation of America, Herndon, Virginia, USA.
Linstrum
Jill
J
Smith
Kathleen
K
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
D000893:Anti-Inflammatory Agents; D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D005938:Glucocorticoids; D008081:Liposomes; D005447:Fluocinonide; D004317:Doxorubicin