Kemoterapinin Tetiklediği Akral Eritem: Vaka Sunumu

Year 2009, Volume: 9 Issue: 1, 49 - 51, 01.01.2009

Serap Özmen Neşe Yaralı Elif Çalışkan Öztürk Bahattin Tunç

Abstract

Kemoterapinin tetiklediği akral eritem, 5-flurouracil, doxo- rubicin ve cytosin arabinosid gibi kemoterapötiklerin neden olduğu lokalize, toksik bir reaksiyondur. Çocukluk yaş gru- bunda ender olarak görülür. B cell ALL tanısı alan vakamız- da, St. Jude Total XIII konsolidasyon tedavisinden üç gün sonra yüz, boyun, göğüs ön duvarında makulopapüler döküntü gelişti. Bir gün sonra hastanın her iki el ayası ve ayak tabanında yaklaşık üç cm çapında çevresi hiperemik, iyi sınırlı, ağrılı, büllöz lezyonlar gelişti. Bu bulgularla has- tada yüksek doz metotreksata bağlı akral eritem ve bülloz reaksiyon düşünüldü. Sonuç olarak, kemoterapötiklere bağlı gelişen akral eritemde, kemoterapi uygulamaları öncesi ve/ veya sırasında sistemik kortikosteroid verilebilir

Keywords

Akral eritem, akut lenfoblastik lösemi, büllöz varyant, çocukluk çağı, ilaç reaksiyonu

Chemotherapy Induced Acral Erythema: A Case Report

Abstract

Chemotherapy induced acral erythema is localized response to some chemotherapeuticals such as 5-fluorouracil, doxo- rubicin, and cytosin arabinosid. It is rarely seen in childho- od. Our patient was diagnosed with B precursor acute lymphoblastic leukemia. Three days after St. Jude Total XIII consolidation therapy, itchy, maculopapular rashes appea- red on her face, neck, and upper trunk. One day later, well- demarcated erythema and several painful, 1-2 cm diameter bullous lesions were seen on her palms and soles, possibily due to methotrexate induced acral erythema and bullous reaction. In conclusion, chemotherapy induced acral erythe- ma might be prevented by corticostreoid use simultaneously or before methotrexate therapy

Keywords

Acral erythema, acute lymphoblastic leukemia, bullous variant, childhood, drug reactions

References

• 1. Azurdia RM, Clark RE, Friedmann PS. Chemotherapyinduced acral erythema (CIAE) with bullous reaction. Clin Dermatol 1999; 24:64-6.
• 2. Demircay Z, Gurbuz O, Alpdogan TB, Yücelten D, Alpdogan O, Kurtkaya O, Bayik M. Chemotherapy-induced acral erythema in leukemic patients: a report of 15 cases. Int J Dermatol 1997; 36:593-8.
• 3. Baack BR, Burgdorf WH. Chemotherapy-induced acral erythema. J Am Acad Dermatol 1991; 24:457-61.
• 4. Susser WS, Whitaker-Worth DL, Grant-Kels JM. Mucocutaneous reactions to chemotherapy. J Am Acad Dermatol 1999; 40:367-98.
• 5. Werchniak AE, Chaffee S, Dinulos JGH. Methotrexate induced bullous acral erythema in a child. J Am Acad Dermatol 2005; 52:93-5.
• 6. Millot F, Auriol F, Brecheteau P. Acral erythema in children receiving high-dose methotrexate. Pediatr Dermatol 1999; 16:398-400.
• 7. Kuruvila S, Dalal M, Sivanesan B. Bullous variant of acral erythema due to methotrexate. Indian J Dermatol Venereol Leprol 2006; 72:440-2.
• 8. Hellier I, Bessis D, Sotto A. High-dose methotrexate-induced bullous variant of acral erythema. Arch Dermatol 1996; 132:590-1.
• 9. Giacchero D, Monpoux F, Chiavérini C, Lacour JP. 6-mercaptopurine-related hand-foot syndrome in a four-yearold child. Ann Dermatol Venereol 2008; 135(8-9):580-3.
• 10. Crider MK, Jansen J, Norins, AL, McHale MS. Chemotherapy-induced acral erythema in patients receiving bone marrow transplantation. Arch Dermatol 1986; 122:1023-7.
• 11. Tezer H, Kuskonmaz B, Kara A, Devrim I, Tuncer M, Cengiz AB, Yetgin S, Secmeeer G. Intravenous immunoglo- bulin in the treatment of severe methotrexate-induced acral eythema. J Pediatr Hematol Oncol 2008; 30:391-3.