A CASE OF BULLOUS ACRAL ERYTHEMA DUE TO BLEOMYCIN

Abstract

Acral erythema is a cutaneous reaction that is frequently caused by chemotherapy agents. Bullous acral erythema is a rare variation of this condition and the reported cases in the literature are related mostly to cytarabine and methotrexate. A 50-year-old male patient presented to our dermatology outpatient clinic with painful lesions of the hands and feet that is present for five days. In his medical history, there was an operation with the diagnosis of right testicular seminoma two years ago and history of taking bleomycin chemotherapy due to a recurrence two months ago. There were painful erythematous plaques and bullae on palmoplantar areas in dermatologic examination. When bullae were drained with a sterile injector, the content is detected to be serous-hemorrhagic fluid. With the current anamnesis and clinical findings the patient was diagnosed to have bullous acral erythema and topical Triticum vulgare extract therapy was started. Acral erythema is a common dermatosis secondary to chemotherapeutic agents and bullous acral erythema is a rare variant. Bullous acral erythema related to bleomycin is rarely reported in the literature, while methotrexate and cytarabine are the frequently accused agents.

Keywords

• Acral,bleomycin,bullous,chemotherpy,erythema

Kaynakça

1. 1. Podjasek JO, Camilleri MJ. Bullous acral erythema. An additional consideration in the differential diagnosis of pauci-inflammatory subepidermal bullae. J Cutan Pathol. 2012;39:382-390.
2. 2. Feizy V, Namazi MR, Barikbin BB, Ehsani A. Methotrexate induced acral erythema with bullous reaction. Dermatol Online J. 2003;9:14.
3. 3. Ozmen S, Dogru M, Bozkurt C, Kocaoglu AC. Probable cytarabine induced acral erythema:report of 2 pediatric cases. J Pediatr Hematol Oncol. 2013;35:11-13.
4. 4. Richards KN, Ivan D, Rashid RM, Chon SY. Paclitaxel induced acral erythema. Arch Dermatol. 2012;148:1333-1334.
5. 5. Azurdia RM, Clark RE, Friedmann PS. Chemotherapy induced acral erythema with bullous reaction. Clin Exp Dermatol. 1999;24:64-66.
6. 6. Tezer H, Kuskonmaz B, Kara A et al. Intravenous immunglubulin in the treatment of severe methotrexate induced acral erythema. J Pediatr Hematol Oncol. 2008;30:391-393.