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September 1990

Necrotizing Vasculitis at Granulocyte-Macrophage-Colony-Stimulating Factor Injection Sites

Author Affiliations

Department of Dermatology

Department of Clinical Immunology and Biological Therapy

Department of Dermatology The University of Texas Medical School 6431 Fannin, MSB 1.186 Houston, TX 77030

Arch Dermatol. 1990;126(9):1243-1244. doi:10.1001/archderm.1990.01670330123030

To the Editor.—  Granulocyte-macrophage-colony-stimulating factor is a 14 to 35 kd glycoprotein cytokine produced by T cells, endothelial cells, and fibroblasts.1 The granulocyte-macrophage-colony-stimulating factor has multiple biologic effects, including stimulation of multipotent colonies, maturation of granulocytes and monocytes, bacterial phagocytosis, and enhancement of antigen-presenting cells.1-3 The granulocyte-macrophage-colony-stimulating Hemorrhagic bulla at granulocyte-macrophage-colony-stimulating factor injection site on the left thigh with surrounding erythematous livedo pattern. factor has been used in aplastic anemia, myelodysplastic syndrome, before and after chemotherapy for neutropenia secondary to the chemotherapy and with bone marrow transplantation, and in acquired immunodeficiency syndrome. The most commonly reported side effects include bone pain, fever, chills, myalgias, arthralgias, decreased appetite, and nausea. Additionally, of 23 patients with advanced malignancy treated with granulocyte-macrophage-colony-stimulating factor, nine had a cutaneous eruption4 consisting of local erythema and pruritus at the injection site, recall erythema at previous injection sites, or a generalized maculopapular rash. We report

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