Acral erythrodysesthesia syndrome caused by intravenous infusion of docetaxel in breast cancer
Acral erythrodysesthesia syndrome caused by intravenous infusion of docetaxel in breast cancer
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DOI：
10.1097/00000421-200212000-00015
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发表时间：
2002-12-01
影响因子：
2.6
通讯作者：
Krieg, T
中科院分区：
文献类型：
--
作者：
Eich, D;Scharffetter-Kochanek, K;Krieg, T
多西紫杉醇引起的皮肤反应包括过敏、浮肿、皮肤毒性和红斑感觉综合征、输液部位反应、脱发、指甲脱落、指甲色素沉着、光敏、硬皮病和其他，如口腔炎和感觉异常。然而，在所有已报道的影响中，肢端红斑性感觉障碍综合征在文献中很少被描述。我们报告了两名女性乳腺癌患者在接受多西紫杉醇治疗后出现肢端红斑性感觉障碍综合征。他们的手脚出现了形状怪异、灼热的皮肤反应。皮肤活检的组织学检查显示，两名患者的汗腺都有微小的小汗腺损伤。多西紫杉醇的皮肤斑贴试验呈阴性。没有关于多西他赛化疗副作用的报道描述了以汗管鳞状化生和外分泌性嗜中性汗腺炎为组织学特征的肢端红斑性感觉障碍综合征。我们认为这些特征性的组织学特征是区别于固定性药疹和局限性移植物抗宿主病的关键。
Docetaxel-induced skin reactions include hypersensitivity, edema, skin toxicity with erythrodysesthesia syndrome, infusion site reactions, alopecia, nail onycholysis, nail pigmentation, photosensitivity, scleroderma, and others, for example, stomatitis and paresthesias. However, of all reported effects, the acral erythrodysesthesia syndrome has only rarely been described in the literature. We report on two female patients with breast cancer who on treatment with docetaxel developed acral erythrodysesthesia syndrome. It presented as bizarrely shaped, burning skin reactions at their hands and feet. Histology of skin biopsies revealed microscopic damages to the eccrine sweat glands in both patients. Skin patch testing with docetaxel was negative. None of the reports dealing with side effects of docetaxel chemotherapy has described acral erythrodysesthesia syndrome with the histologic features of syringosquamous metaplasia and eccrine neutrophilic hidradenitis. We propose here that these characteristic histologic features are essential in the differentiation from fixed drug eruption and localized graft-versus-host disease.