title: Intravenous immunoglobulin in the treatment of severe methotrexate-induced acral erythema.
abstract: Chemotherapy-induced acral erythema is an uncommon and dramatic reaction to high-dose chemotherapy. It is characterized by painful erythema of both palms and soles with symmetrically well-defined borders, which may progress to bullae formation and desquamation. The bullous variant of this reaction has been reported with methotrexate and more frequently cytosine arabinoside. Rapid differential diagnosis and discrimination from more serious conditions such as graft versus host disease or toxic epidermal necrolysis is essential. In this case report, we present a 13-year-old boy who developed severe and prolonged chemotherapy-induced acral erythema after high-dose methotrexate treatment and successfully responded to intravenous immunoglobulin.
authors.affiliation: Pediatric Infectious Disease Unit, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Tezer
authors.forename: Bars
authors.initials: B
authors.lastname: Kuskonmaz
authors.forename: Ates
authors.initials: A
authors.lastname: Kara
authors.forename: Ilker
authors.initials: I
authors.lastname: Devrim
authors.forename: Murat
authors.initials: M
authors.lastname: Tuncer
authors.forename: Ali Bulent
authors.initials: AB
authors.lastname: Cengiz
authors.forename: Sevgi
authors.initials: S
authors.lastname: Yetgin
authors.forename: Gülten
authors.initials: G
authors.lastname: Seçmeer
mesh_terms: D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004890:Erythema / Q000139:chemically induced* / Q000188:drug therapy*; D005534:Foot Diseases / Q000139:chemically induced / Q000188:drug therapy; D006229:Hand Dermatoses / Q000139:chemically induced / Q000188:drug therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000009:adverse effects*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*
chemical_list: D000964:Antimetabolites, Antineoplastic; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D008727:Methotrexate