Pustular acral erythema in a patient with acute graft-versus-host disease.
Acral erythema is a well-known side-effect of chemotherapy treatment but it is not common in patients undergoing bone marrow transplant. We report a post-transplant patient with clinical and histological acute graft-versus-host disease (GVHD) who concurrently developed acral erythema presenting as painful, well-defined and self-limiting palmar erythema with pustules. A skin biopsy from the palm showed abnormal keratinocyte maturation and eccrine squamous syringometaplasia. This case illustrates the difficulties in establishing the differential diagnosis of cutaneous eruptions in patients undergoing bone marrow transplant.
Ruiz-Genao
D P
DP
Departments of Dermatology and Pathology, Hospital Universitario de La Princesa, Madrid, Spain. ddruizes@yahoo.com
GF-Villalta
M J
MJ
Peñas
P F
PF
Fraga
J
J
García-Díez
A
A
Fernández-Herrera
J
J
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001707:Biopsy, Needle; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000379:methods; D018450:Disease Progression; D004890:Erythema / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D017809:Fatal Outcome; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000473:pathology*; D006229:Hand Dermatoses / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D008297:Male; D012720:Severity of Illness Index; D012872:Skin Diseases, Vesiculobullous / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology*
D000305:Adrenal Cortex Hormones