Crawford Julie H, Eikelboom John W, McQuillan Andrew
Royal Perth Hospital, Perth, Western Australia, Australia.
Eur J Haematol. 2002 Nov-Dec;69(5-6):315-7. doi: 10.1034/j.1600-0609.2002.02834.x.
Palmar-plantar erythrodysaesthesia (PPE) is an uncommon cutaneous complication of cytotoxic chemotherapy which generally presents as a painful erythema involving the palms and soles. It has been suggested that PPE caused by cytarabine does not recur with subsequent cytarabine re-challenge. We report a patient with recurrent, increasingly severe episodes of PPE, ultimately complicated by a severe bullous eruption, following successive cycles of high-dose cytarabine for the treatment of acute lymphoblastic leukaemia. Contrary to previous recommendations, our experience cautions against the further use of high-dose cytarabine in patients who develop PPE, and is a timely reminder of the potential toxicity of this agent, which is now increasingly being used as first-line treatment in the management of haematologic malignancies.
手足红斑感觉异常（PPE）是细胞毒性化疗罕见的皮肤并发症，通常表现为累及手掌和足底的疼痛性红斑。有观点认为，阿糖胞苷所致的PPE在后续再次使用阿糖胞苷时不会复发。我们报告了1例急性淋巴细胞白血病患者，在接受大剂量阿糖胞苷连续多个周期治疗后，出现反复且日益严重的PPE发作，最终并发严重的大疱性皮疹。与之前的建议相反，我们的经验警示，对于发生PPE的患者应避免进一步使用大剂量阿糖胞苷，这也适时提醒了该药物的潜在毒性，目前该药越来越多地被用作血液系统恶性肿瘤治疗的一线用药。
