Radiation recall dermatitis, panniculitis, and myositis following cyclophosphamide therapy -: Histopathologic findings of a patient affected by multiple myeloma
Radiation recall dermatitis, panniculitis, and myositis following cyclophosphamide therapy -: Histopathologic findings of a patient affected by multiple myeloma
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DOI：
10.1097/00000372-200406000-00008
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发表时间：
2004-06-01
影响因子：
1.1
通讯作者：
Franchini, P
中科院分区：
文献类型：
--
作者：
Borroni, G;Vassallo, C;Franchini, P
放射性回忆性皮炎是一种可能影响肿瘤患者的皮肤后遗症。它发生在先前照射的区域，当随后给予化疗时。皮疹可能由化疗引起，甚至在放疗后几个月。其机制知之甚少，迄今为止，组织病理学结果仅得到粗略的解释。一名55岁男性多发性骨髓瘤患者在左侧髋股区域和腰椎区域（D11-L1）接受了放射治疗。在使用环磷酰胺后，他在先前的照射野中发展出两个边界清楚的方形浸润性紫色斑块。组织学结果显示弥漫性纤维硬化过程，涉及真皮深层、皮下组织以及下面的肌肉，而表皮和真皮浅中层则不受影响。组织学与深部放射性皮炎、脂膜炎和肌炎难以区分。这是第一例提供明确证据证明环磷酰胺在诱导皮肤和皮下放射回忆反应中的致病作用的病例。
Radiation recall dermatitis is one of the skin sequelae that may affect oncology patients. It occurs in a previously irradiated field, when subsequent chemotherapy is given. The eruption may be elicited by chemotherapy, even several months after radiotherapy. Its mechanism is poorly understood, and the histopathologic findings have received, to date, only sketchy descriptions.A 55-year-old male affected by multiple myeloma received radiation therapy both on his left coxofemoral area, and lumbar region (D11-L1). After cyclophosphamide administration, he developed 2 well defined square-shaped, infiltrated erythematoviolaceous plaques in the prior irradiated fields.Histopathologic findings revealed a diffusely fibrosclerosing process, involving deep dermis, hypodermis, as well as the underlying muscle, while sparing the epidermis and superficial-mid dermis. Histopathology was indistinguishable from deep radio-dermatitis, panniculitis, and myositis. This is the first case providing clear evidence of the causative role of cyclophosphamide in inducing a cutaneous and subcutaneous radiation recall reaction.