title: Recurrent palmar-plantar erythrodysaesthesia following high-dose cytarabine treatment for acute lymphoblastic leukemia.
abstract: Palmar-plantar erythrodysaesthesia (PPE) is an uncommon cutaneous complication of cytotoxic chemotherapy which generally presents as a painful erythema involving the palms and soles. It has been suggested that PPE caused by cytarabine does not recur with subsequent cytarabine re-challenge. We report a patient with recurrent, increasingly severe episodes of PPE, ultimately complicated by a severe bullous eruption, following successive cycles of high-dose cytarabine for the treatment of acute lymphoblastic leukaemia. Contrary to previous recommendations, our experience cautions against the further use of high-dose cytarabine in patients who develop PPE, and is a timely reminder of the potential toxicity of this agent, which is now increasingly being used as first-line treatment in the management of haematologic malignancies.
authors.affiliation: Royal Perth Hospital, Perth, Western Australia, Australia. Julie.Crawford@health.wa.gov.au
authors.forename: Julie H
authors.initials: JH
authors.lastname: Crawford
authors.forename: John W
authors.initials: JW
authors.lastname: Eikelboom
authors.forename: Andrew
authors.initials: A
authors.lastname: McQuillan
mesh_terms: D000328:Adult; D000075202:Contraindications; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology; D004890:Erythema / Q000139:chemically induced; D005533:Foot Dermatoses / Q000139:chemically induced; D006229:Hand Dermatoses / Q000139:chemically induced; D006801:Humans; D008297:Male; D010292:Paresthesia / Q000139:chemically induced*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy*; D012008:Recurrence; D012871:Skin Diseases / Q000139:chemically induced*
chemical_list: D003561:Cytarabine