Chemotherapy-Induced Acral Erythema in Patients Receiving Bone Marrow Transplantation

Crider, Michael Kenneth; Jansen, Jan; Norins, Arthur L.; McHale, Michael S.

doi:10.1001/archderm.1986.01660210073021

Cited by 53 publications

(12 citation statements)

References 17 publications

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“…Furthermore, the condition showed improvement within a short period of time, and was not associated with other systemic symptoms. On the other hand, our histopathological findings were compatible with both CAE and GVHD, 4,5 , 8,9 or were even compatible with acute GVHD based on a previous report, as in CAE there is usually no liquefaction or lymphocytic infiltration, in marked contrast with acute GVHD. 10 Further studies are required to determine whether the histopathological findings in our patient accidentally resembled those of acute GVHD, or whether pathological mechanisms of CAE are similar to those of acute GVHD.…”

Section: Reportsupporting

confidence: 87%

Chemotherapy-induced acral erythema: report of a case and immunohistochemical findings

Tsuruta¹,

Mochida²,

Hamada³

et al. 2000

Clinical and Experimental Dermatology

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Chemotherapy-induced acral erythema (CAE) is an uncommon and distinct reaction seen in patients receiving high-dose chemotherapy. The exact pathogenic mechanisms of this disorder are still unknown. We report a 27-year-old woman who presented with red, swollen and painful macules on both palms, clinically consistent with this disease. Histological examination demonstrated vacuolar degeneration of the basal cell layer and spongiotic blisters in the epidermis, especially in the atrophied eccrine ducts and papillary oedema with mild perivascular infiltration of mononuclear and hypersegmented neutrophils. Immunohistochemistry showed that the infiltrating mononuclear cells were CD3-CD16+CD56+ leucocyte function antigen-1+, possibly natural killer cells. The eccrine ducts expressed HLA-DR and intracellular adhesion molecule-1 (ICAM-1). Our findings suggest that cell-to-cell interaction between NK cells and keratinocytes in the eccrine apparatus may induce CAE and may be involved in the pathogenesis of the skin reaction in our patient and possibly in this disease.

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Section: Reportsupporting

confidence: 87%

Chemotherapy-induced acral erythema: report of a case and immunohistochemical findings

Tsuruta¹,

Mochida²,

Hamada³

et al. 2000

Clinical and Experimental Dermatology

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“…HFSR is the sorafenib dermatologic toxicity with the greatest frequency and the greatest morbidity. HFSR associated with sorafenib therapy affects friction and weight-bearing acral surfaces more focally than the classic hand-foot syndrome that has been reported with traditional chemotherapeutic agents such as cytarabine, fluorouracil, and methotrexate (Table 2) (18, 19). …”

Section: Discussionmentioning

confidence: 99%

Hand-Foot Skin Reaction Increases with Cumulative Sorafenib Dose and with Combination Anti-Vascular Endothelial Growth Factor Therapy

Azad¹,

Aragon‐Ching²,

Dahut³

et al. 2009

Clinical Cancer Research

130

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Purpose: Sorafenib, a vascular endothelial growth factor (VEGF) receptor-2 and RAF kinase inhibitor, commonly causes skin toxicity. We retrospectively analyzed dermatologic toxicity in patients receiving combined antiangiogenic therapy involving sorafenib and bevacizumab. Experimental Design: Castration-resistant prostate cancer and metastatic non-small cell lung cancer patients were accrued to phase II studies, receiving sorafenib 400 mg twice daily. A phase I study explored sorafenib 200 to 400 mg twice daily with bevacizumab 5 to 10 mg/kg every 2 weeks in patients with advanced solid tumors. The probability of development of maximum grade of dermatologic toxicity as a function of the cumulative dose of sorafenib was determined. Additional analyses compared extent of toxicity, pharmacokinetics, and patient risk factors. Results: Ninety-six patients were enrolled: 54 received sorafenib and 42 received bevacizumab/ sorafenib. Hand-foot skin reaction (HFSR) was observed in 50 of 96 (52%) patients. Grade 2 to 3 HFSR developed in 16 of 54 (30%) sorafenib patients and 24 of 42 (57%) bevacizumab/ sorafenib patients (P = 0.012) and was associated with cumulative sorafenib exposure (P = 0.0008). Twenty-four of 42 phase I patients randomized to start with bevacizumab had increased risk of grade 2 to 3 HFSR than those starting with sorafenib (P = 0.013) after adjusting for association between HFSR risk and hypertension (P = 0.01), which was the only toxicity associated with HFSR. There was no association between HFSR and baseline history of neuropathy, prior taxane/platinum treatment, or systemic sorafenib levels. Conclusions: Sorafenib-related HFSR is associated with increasing cumulative sorafenib dose. HFSR is increased in patients treated with bevacizumab/sorafenib combination anti-VEGF therapy, and this finding is not explained by pharmacokinetic interaction between the two agents. Our results suggest that the pathophysiology of HFSR may be related to VEGF inhibition.

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“…Even in larger series, no extensive pigmentary abnormalities have been recorded in association with CAE. 4,5 Daunorubicin is well documented to cause hyperpigmentation mainly on nails of black people, but skin pigmentation has rarely been reported with this drug. 6,7 In a single case report hyperpigmentation due to cyclosporin therapy was described with particular involvement of the flexural creases.…”

Section: To the Editormentioning

confidence: 99%

Bullous acral erythema and concomitant pigmentation on the face and occluded skin

Özkaya‐Bayazit

Diz‐Küçükkaya²,

Akasya³

et al. 2000

Acad Dermatol Venereol

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Chemotherapy-Induced Acral Erythema in Patients Receiving Bone Marrow Transplantation

Cited by 53 publications

References 17 publications

Chemotherapy-induced acral erythema: report of a case and immunohistochemical findings

Chemotherapy-induced acral erythema: report of a case and immunohistochemical findings

Hand-Foot Skin Reaction Increases with Cumulative Sorafenib Dose and with Combination Anti-Vascular Endothelial Growth Factor Therapy

Bullous acral erythema and concomitant pigmentation on the face and occluded skin

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