The limited role of corticosteroids in ameliorating experimental doxorubicin skin toxicity in the mouse.

Local skin necrosis is a serious complication of doxorubicin (Adriamycin) infiltration in man. Intradermal (ID) doxorubicin infection was used in the mouse to create skin lesions, after which a number of local corticosteroid interventions were studied. The most effective local antidote was low-dose (2.5 mg) hydrocortisone (HC), but only against the low-dose doxorubicin challenge (0.05 mg). Other andidotes with lesser effectiveness included dexamethasone-sodium bicarbonate and an intermediate dose of HC (6.25 mg). Larger doses of ID HC did not prevent local doxorubicin toxicity and were inherently toxic to the skin. Systemic corticosteroids were similarly ineffective. The superiority of the low ID HC dose, the ineffectiveness of additions (sodium bicarbonate, topical HC cream), and the resistance of the high-dose doxorubicin ID challenge (0.5 mg) suggests a limited role for corticosteroids in the management of experimental doxorubicin skin toxicity.