title: Toxic erythema of chemotherapy following leukemia cutis.
abstract: A 56-year-old Caucasian male newly diagnosed with acute myelogenous leukemia (AML) M3 presented with a six-week history of multiple painful erythematous nodules scattered on his trunk and extremities, previously treated as abscesses with incision and drainage plus oral trimethoprim-sulfamethoxazole without improvement. A punch biopsy was performed, and the histopathology and immunostaining profile were compatible with leukemia cutis secondary to AML. Induction chemotherapy for AML with cytarabine, etoposide, and mitoxantrone was initiated. Dermatology was reconsulted two weeks later for evaluation and treatment of a new eruption on both dorsal hands and wrists that began three days after starting induction chemotherapy. On physical exam, there were well-demarcated erythematous patches and plaques with mild induration on the hands, extending onto the distal forearms and sparing the dorsal metacarpalphalangeal joints and ventral wrists. Biopsy findings were consistent with toxic erythema of chemotherapy, likely secondary to cytarabine.
authors.affiliation: Ms Kaskas is with the Louisiana State University Health School of Medicine in Shreveport.
authors.forename: Nadine
authors.initials: N
authors.lastname: Kaskas
authors.affiliation: Dr DiGiorgio is with the Department of Dermatology at the Louisiana State University Health Sciences Center in New Orleans and the Ochsner Clinic Foundation, Department of Dermatology in New Orleans.
authors.forename: Catherine
authors.initials: C
authors.lastname: DiGiorgio
authors.affiliation: Dr Vincent is with the Department of Dermatology at the Louisiana State University Health Sciences Center in New Orleans and the Ochsner Clinic Foundation, Department of Dermatology in New Orleans.
authors.forename: Bethaney
authors.initials: B
authors.lastname: Vincent
authors.affiliation: Dr Walia is with the Department of Dermatology at the Louisiana State University Health Sciences Center in New Orleans and the Ochsner Clinic Foundation, Department of Dermatology in New Orleans.
authors.forename: Suneeta
authors.initials: S
authors.lastname: Walia
authors.affiliation: Dr Mermilliod is with the Department of Dermatology at the Louisiana State University Health Sciences Center in New Orleans and the Ochsner Clinic Foundation, Department of Dermatology in New Orleans.
authors.forename: Julie
authors.initials: J
authors.lastname: Mermilliod
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use; D003561:Cytarabine / Q000009:adverse effects* / Q000627:therapeutic use; D004890:Erythema / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy; D005047:Etoposide / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D060828:Induction Chemotherapy / Q000009:adverse effects*; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000009:adverse effects / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D003561:Cytarabine; D005047:Etoposide; D008942:Mitoxantrone