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February 1993

A Papulovesicular Eruption in a Man Receiving Chemotherapy for Metastatic Melanoma

Author Affiliations

University of Arizona, Tucson

Arch Dermatol. 1993;129(2):235-236. doi:10.1001/archderm.1993.01680230121019

REPORT OF A CASE  A 67-year-old white man with metastatic melanoma began therapy with continuous intravenous suramin infusion. On the third day of treatment, an asymptomatic eruption developed over his upper trunk and arms. Numerous nonconfluent 2- to 3-mm papules, pustules, and vesicles on an erythematous base were present (Fig 1). They were randomly distributed. The patient otherwise felt well, and the findings from his physical examination were normal, except for the cutaneous changes.A punch biopsy specimen of one of the papules is shown in Figs 2 through 4.What is your diagnosis?

DIAGNOSIS:  Squamous syringometaplasia (squamous metaplasia) of the eccrine glands.

HISTOPATHOLOGIC FINDINGS  An acanthotic squamous epithelium with overlying parakeratosis was seen. Moderate dysplastic features were present in the epidermal keratinocytes and the acrosyringium. A mild chronic inflammatory infiltrate was seen in the upper dermis. The dermal eccrine coil and glands were uninvolved

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