Constantinou A, Kotecha D, Laouris P, de Paula B
School of Clinical Medicine University of Cambridge Cambridge UK.
Department of Oncology University of Cambridge Cambridge UK.
Skin Health Dis. 2022 Jan 19;2(1):e92. doi: 10.1002/ski2.92. eCollection 2022 Mar.
Flagellate dermatitis (FD) is a rare skin rash, which may occur following the administration of antineoplastic agents. It has been reported following the administration of bleomycin, docetaxel, trastuzumab, cisplatin, bendamustine and doxorubicin. We provide a summary of the epidemiology, aetiology, pathophysiology, and distribution of chemotherapy-induced FD.
PubMed was searched using ((flagellat*) AND (Dermat*)) OR ((Flagellat*) AND (Erythema)). The search yielded 206 publications, out of which 54 individual case reports were identified which fulfilled our inclusion criteria. Statistical analysis was performed where appropriate.
Female patients were slightly more likely to develop FD compared to males. In the majority of cases FD appeared on the upper and lower limbs and pruritus was an accompanying feature in 51% of cases. Most cases developed after the first cycle of chemotherapy and females were statistically more likely to present within the first 72 hr ( <0.05). Skin biopsies were taken in 41% of cases and this was not statistically associated with the patient's gender, ( = 0.651), presentation within 72 hr ( = 0.076) or cancer diagnosis. Chemotherapy was stopped in 62% of patients and was associated with female gender ( = 0.0098). Most patients who received treatment were managed with topical steroids. Time for rash resolution ranged from a few weeks to four months following the discontinuation of the causative drug.
FD is a rare adverse skin effect of chemotherapeutic treatment, most commonly presenting on the upper and lower limbs of patients following their first cycle of chemotherapy. Early presentation is more common in females leading to increased likelihood of stopping chemotherapy. Biopsy findings poorly correlate with disease severity. Continuation of chemotherapy treatment in combination with topical steroids may not adversely affect rash resolution.
鞭毛虫性皮炎（FD）是一种罕见的皮疹，可能在使用抗肿瘤药物后出现。据报道，在使用博来霉素、多西他赛、曲妥珠单抗、顺铂、苯达莫司汀和阿霉素后会出现这种情况。我们总结了化疗诱导的FD的流行病学、病因、病理生理学和分布情况。
在PubMed上使用（（鞭毛虫*）AND（皮肤病*））或（（鞭毛虫*）AND（红斑））进行搜索。搜索结果有206篇出版物，其中54篇个案报告符合我们的纳入标准。在适当情况下进行了统计分析。
女性患者发生FD的可能性略高于男性。在大多数病例中，FD出现在上肢和下肢，51%的病例伴有瘙痒。大多数病例在化疗的第一个周期后出现，女性在最初72小时内出现的可能性在统计学上更高（<0.05）。41%的病例进行了皮肤活检，这与患者的性别（=0.651）、72小时内出现（=0.076）或癌症诊断无统计学关联。62%的患者停止了化疗，这与女性性别有关（=0.0098）。大多数接受治疗的患者使用局部类固醇进行处理。皮疹消退的时间在停用致病药物后从几周到四个月不等。
FD是化疗治疗罕见的不良皮肤反应，最常见于患者化疗的第一个周期后出现在上肢和下肢。早期出现的情况在女性中更常见，导致停止化疗的可能性增加。活检结果与疾病严重程度相关性较差。继续化疗并结合局部类固醇治疗可能不会对皮疹消退产生不利影响。
