[6-mercaptopurine-related hand-foot syndrome in a four-year-old child].
BACKGROUND
Hand-foot syndrome (HFS) is a dose-dependent cutaneous side effect of cytostatic chemotherapy. It has also been described under the names of acral erythema and palmoplantar erythrodysesthesia. We report a case of HFS during treatment of acute lymphoblastic leukemia with 6-mercaptopurine (6-MP) (Purinethol) in a four-year-old child.


METHODS
A four-year-old boy treated for acute lymphoblastic leukemia developed dry and painful palmar and plantar erythema with fissures. The rash began three weeks after up-titration of 6-MP. There was no past history of cutaneous disease and no other potential trigger factors. The rash ceased after 6-MP withdrawal.


CONCLUSIONS
To our knowledge, this is the first case of HFS due to 6-MP therapy in a child. 6-MP is a major reference drug for the management of acute lymphoblastic leukemia. Numerous cytostatic drugs have been involved in such eruptions.
Giacchero
D
D
Service de dermatologie, hôpital Archet-2, CHU de Nice, B.P. 3079, 06202 Nice cedex 3, France. damiengiacchero@gmail.com
Monpoux
F
F
Chiavérini
C
C
Lacour
J-P
JP
D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D002675:Child, Preschool; 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; D015122:Mercaptopurine / Q000009:adverse effects*; D010292:Paresthesia / Q000139:chemically induced*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D013997:Time Factors
D000964:Antimetabolites, Antineoplastic; D015122:Mercaptopurine