Crider M K, Jansen J, Norins A L, McHale M S
Arch Dermatol. 1986 Sep;122(9):1023-7.
Chemotherapy-induced acral erythema is an uncommon and distinctive syndrome of intense macular erythema of the palms and fingers seen in patients treated with high-dose chemotherapy. It is painful, may form bullae, and heals uneventfully with desquamation. The incidence (35%) of this complication in patients receiving bone marrow transplantation at our institution is quite high and probably reflects the exceptional doses of chemotherapy and concomitant total body irradiation these patients receive. Biopsy specimens showed vacuolar change, spongiosis, necrotic keratinocytes, and epidermal atypia. These findings probably result from direct toxic effect and mimic those of acute graft-vs-host disease. Awareness of chemotherapy-induced acral erythema is important to avoid its misdiagnosis as a cutaneous sign of acute graft-vs-host disease. This distinction can usually be made on clinical grounds. If necessary, serial skin biopsy specimens are helpful.
化疗引起的手足红斑是一种罕见且独特的综合征，表现为接受大剂量化疗的患者手掌和手指出现强烈的斑状红斑。它会引起疼痛，可能形成水疱，并在脱屑后顺利愈合。在我们机构接受骨髓移植的患者中，这种并发症的发生率（35%）相当高，这可能反映了这些患者接受的化疗剂量极高以及同时进行的全身照射。活检标本显示有空泡改变、海绵形成、坏死的角质形成细胞和表皮异型性。这些发现可能是直接毒性作用的结果，与急性移植物抗宿主病的表现相似。认识到化疗引起的手足红斑对于避免将其误诊为急性移植物抗宿主病的皮肤表现很重要。这种区分通常可以基于临床依据做出。如有必要，连续的皮肤活检标本会有所帮助。
