Prussick R, Horn T D, Wilson W H, Turner M C
Dermatology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
J Am Acad Dermatol. 1996 Nov;35(5 Pt 1):705-9. doi: 10.1016/s0190-9622(96)90725-2.
Patients who received recombinant interleukin-1 alpha (IL-1 alpha) before chemotherapy followed by autologous bone marrow transplantation had a characteristic intertriginous cutaneous eruption that has not previously been described.
Our aim was to document these skin changes and to determine whether IL-1 alpha as a sole agent caused recognizable changes in the skin.
A prospective study of the skin changes in eight patients was performed. We characterized the clinical, histologic, and immunohistochemical features of the patient's skin after IL-1 alpha infusions and after chemotherapy.
No specific clinical or histologic changes were seen immediately after IL-1 alpha infusions. Immunohistochemical studies showed significant upregulation of endothelial leukocyte adhesion molecule-1 (ELAM-1) expression. Within 1 day of the initiation of chemotherapy (ifosfamide, carboplatin, and etoposide), a cutaneous eruption consisting of mucositis and varying degrees of erythema progressing to painful erosions in body folds and under adhesive tape developed in all patients. Histologic features were consistent with a chemotherapeutic effect on the epidermis as well as eccrine and apocrine glands. Expression of keratinocyte intercellular adhesion molecule-1 and HLA-DR as well as of ELAM-1 on dermal endothelial cells was increased. The perivascular lymphocytic infiltrate consisted mainly of CD4+ T cells.
High-dose chemotherapy with ifosfamide, carboplatin, and etoposide resulted in a characteristic cutaneous eruption that is consistent with a toxic reaction to chemotherapeutic agents. Its accentuation in skin folds and under taped areas suggests that eccrine excretion of the drugs or a toxic metabolite is an important contributing factor. IL-1 alpha may induce the expression of ELAM-1 but does not cause a cutaneous eruption.
在化疗前接受重组白细胞介素 -1α（IL-1α）治疗随后进行自体骨髓移植的患者出现了一种此前未被描述过的特征性间擦疹。
我们的目的是记录这些皮肤变化，并确定IL-1α作为单一药物是否会引起皮肤的可识别变化。
对8例患者的皮肤变化进行了前瞻性研究。我们对患者在输注IL-1α后及化疗后的皮肤临床、组织学和免疫组化特征进行了描述。
输注IL-1α后即刻未观察到特定的临床或组织学变化。免疫组化研究显示内皮白细胞黏附分子-1（ELAM-1）表达显著上调。在开始化疗（异环磷酰胺、卡铂和依托泊苷）的1天内，所有患者均出现了由黏膜炎和不同程度红斑组成的皮疹，皮疹在身体褶皱处和胶带下方发展为疼痛性糜烂。组织学特征与化疗对表皮以及小汗腺和大汗腺的作用一致。角质形成细胞间黏附分子-1、HLA-DR以及真皮内皮细胞上的ELAM-1表达增加。血管周围淋巴细胞浸润主要由CD4 + T细胞组成。
异环磷酰胺、卡铂和依托泊苷的大剂量化疗导致了一种特征性的皮肤皮疹，这与对化疗药物的毒性反应一致。其在皮肤褶皱处和胶带下方加重表明药物或有毒代谢产物通过小汗腺排泄是一个重要的促成因素。IL-1α可能诱导ELAM-1的表达，但不会引起皮肤皮疹。
