Images in Clinical Medicine
Palmar–Plantar Rash with Cytarabine Therapy
N Engl J Med 2011; 364:e5January 20, 2011DOI: 10.1056/NEJMicm1006530
- Article
A 52-year-old man with acute myeloid leukemia underwent induction chemotherapy consisting of a 7-day intravenous infusion of cytarabine plus daunorubicin on days 1 through 3. Bone marrow biopsy performed on day 14 revealed that blast cells still accounted for 60 to 80% of the total cells in the marrow, indicating an inadequate response to initial induction therapy. Intermediate-dose cytarabine (1500 mg per square meter of body-surface area) was then administered every 12 hours for a total of 12 doses. After the ninth dose, the patient's palms became red and painful. He received a diagnosis of cytarabine-induced palmar–plantar erythrodysesthesia (also known as the hand–foot syndrome, acral erythema, or Burgdorf's reaction). Over the next few days, well-demarcated erythematous plaques, bullae, and desquamation developed over his hands (Panels A and B) and feet. A large vesicle formed on his left heel (Panel C). He was given supportive care, and the acral erythema completely resolved by 20 days after the last dose of cytarabine.
Lindsay Rosenbeck, Pharm.D.
Patrick J. Kiel, Pharm.D.
Indiana University Simon Cancer Center, Indianapolis, IN
lrosenb1@clarian.org - Citing Articles (1)
Citing Articles
1
Yi Zhang, Jin-ming Yang. (2011) The impact of cellular senescence in cancer therapy: is it true or not?. Acta Pharmacologica Sinica 32:10, 1199-1207
