Jaruvijitrattana Pitchaya, Chanprapaph Kumutnart
Division of Dermatology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Case Rep Dermatol. 2019 Jul 25;11(2):226-232. doi: 10.1159/000501876. eCollection 2019 May-Aug.
Cytarabine is an antimetabolite commonly used to treat hematological malignancies, especially acute myeloid leukemia (AML), acute lymphoblastic leukemia, and non-Hodgkin's lymphoma. Cytarabine-induced cutaneous adverse effects are common, usually manifesting as morbilliform eruptions predominantly on the acral site, intertriginous zone, and to a lesser extent on the elbows, knees, neck, and ears. The presentation on ears is usually called "Ara-C ears," which is considered as a rare subtype of acral erythema. We report a 53-year-old Thai woman with AML who developed cytarabine-induced rashes. The lesions began on symmetrical bilateral ears, posterior auricular areas, and forehead followed by expansion to the trunk and extremities. The clinical presentations and histopathological findings were compatible with toxic erythema of chemotherapy. After giving cetirizine 10 mg orally twice daily and 0.1% triamcinolone acetonide cream twice daily, the lesions gradually improved over 10 days. Notably, two additional courses of high-dose cytarabine were administered without any recurrence.
阿糖胞苷是一种常用于治疗血液系统恶性肿瘤的抗代谢药物，尤其适用于急性髓系白血病（AML）、急性淋巴细胞白血病和非霍奇金淋巴瘤。阿糖胞苷引起的皮肤不良反应很常见，通常表现为主要出现在手足部位、褶皱部位的麻疹样皮疹，在肘部、膝盖、颈部和耳部出现的情况较少。耳部出现的皮疹通常称为“Ara-C耳”，被认为是手足红斑的一种罕见亚型。我们报告了一名53岁的泰国女性AML患者，她出现了阿糖胞苷引起的皮疹。皮疹始于双侧对称的耳部、耳后区域和前额，随后扩展至躯干和四肢。临床表现和组织病理学结果与化疗所致毒性红斑相符。在每天口服两次10毫克西替利嗪和每天两次外用0.1%曲安奈德乳膏后，皮疹在10天内逐渐好转。值得注意的是，后续又进行了两个疗程的大剂量阿糖胞苷治疗，皮疹未再复发。
