To the Editor.—
Chemotherapy-induced acral erythema (CIAE) is a rare response to cytotoxic agents that involves painful, well-demarcated erythematous plaques. These plaques usually occur on the palmar and dorsal surface of the hands and, less frequently, on the soles and dorsa of the feet. Some cases, however, progress to bullae formation with subsequent desquamation and sloughing.1After encountering a case of bullous CIAE, we discovered an interesting trend in our review of the literature. Patients in whom CIAE developed following treatment with cytarabine, alone or in combination with other agents, have a predilection to progress to the bullous form of CIAE.2-6 Conversely, those patients receiving doxorubicin and/or fluorouracil are much more likely to have the nonbullous variation of acral erythema develop.
Report of a Case.—
A 31-year-old man with acute lymphocytic leukemia was admitted for an allogenic bone marrow transplantation. Induction therapy in preparation for undergoing the transplantation included cytarabine
Waltzer JF, Flowers FP. Bullous Variant of Chemotherapy-Induced Acral Erythema. Arch Dermatol. 1993;129(1):43-45. doi:10.1001/archderm.1993.01680220055012