Images in Clinical Medicine

Kim Eagle, M.D., Editor

Chemotherapy-Induced Acral Erythema

Mario Pirisi, M.D., and Giorgio Soardo, M.D.

N Engl J Med 1994; 330:1279May 5, 1994

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Article

Figure 1 Chemotherapy-Induced Acral Erythema.

Acral cyanosis can be seen in a 61-year-old woman with non-Hodgkin's lymphoma. The lesions developed while the patient had severe neutropenia during a course of therapy consisting of methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin. The disorder is characterized by intense, painful erythema of the palms and soles, often culminating in the formation of vesicles or bullae. Chemotherapeutic agents are one of the known causes.

Kim Eagle, M.D.

Mario Pirisi, M.D.
Giorgio Soardo, M.D.
Cattedra di Medicina Interna Universita degli Studi, 33100 Udine, Italy

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