[Hypersensitivity reactions to multiple drugs during the course of hairy cell leukemia treated with 2-chlorodeoxyadenosine].

A 38-year-man developed diffuse erythema 3 days after the administration of 2-chlorodeoxyadenosine (cladribine or 2-CdA) and many other drugs for hairy cell leukemia (HCL). Patch-testing and scratch patch-testing showed positive reactions for clindamycin (10%, 30%) at 24 hours and 48 hours. Furthermore, provocation-testing showed positive reactions for sulfamethoxazole.trimethoprim, allopurinol, fluconazole, so our diagnosis was erythroderma-type drug eruption due to clindamycin, sulfamethoxazole-trimethoprim, allopurinol, fluconazole. Cutaneous side-effects associated with cladribine have seldom been described in cases of HCL. Our case suggests that there is a relationship between the drug hypersensitivity and the prolonged suppressed CD4 cell levels caused by cladribine.