Cox G J, Robertson D B
Arch Dermatol. 1986 Dec;122(12):1413-4.
We encountered a case of distinctive palmar-plantar erythema with desquamation of the fingers in a patient receiving high-dose mercaptopurine combined with allopurinol. He was receiving 400 mg/d of mercaptopurine with 200 mg/d of allopurinol when a painful, livid erythema involving his hands and feet developed. Over the ensuing 24 hours, desquamation of the distal fingertips was noted. The mercaptopurine was discontinued and the patient was treated with topical fluocinonide ointment under occlusion. Over the next 96 hours, the erythema and pain resolved entirely. To date, this is the eighth case of a painful desquamating erythema of the palms and soles occurring as a complication of chemotherapy. We suggest that high-dose mercaptopurine combined with allopurinol that blocks xanthine oxidase, a necessary enzyme in the catabolism of mercaptopurine, was responsible for our patient's clinical presentation.
我们遇到了一例在接受大剂量巯嘌呤联合别嘌醇治疗的患者中出现独特的掌跖红斑并伴有手指脱屑的病例。他正在接受每日400毫克巯嘌呤和每日200毫克别嘌醇治疗，此时出现了累及双手和双脚的疼痛性、青紫色红斑。在随后的24小时内，观察到远端指尖脱屑。巯嘌呤停药，患者在封闭状态下接受外用氟轻松软膏治疗。在接下来的96小时内，红斑和疼痛完全消退。迄今为止，这是作为化疗并发症发生的掌跖疼痛性脱屑性红斑的第八例。我们认为，大剂量巯嘌呤联合别嘌醇（别嘌醇可阻断黄嘌呤氧化酶，而黄嘌呤氧化酶是巯嘌呤分解代谢中必需的酶）是导致我们患者临床表现的原因。
