Three Cases of Docetaxel-induced Acral Erythema

Cho, Jae Hoon; Kim, Mi Yeon; Park, Young Min; Kim, Hyung Ok

Abstract

Chemotherapy-induced acral erythema ia a rare cutaneous reaction to high dose chemotherapy, clinically presenting with painful erythema on the palms and soles. Docetaxel-induced acral erythema is unique in that it usually occurrs on atypical sites, the dorsum of hands and peri-maleolar area. Recently, we experienced three patients with internal malignancy such as lung or ovary cancer who developed painful erythematous to violaceous patches of the dorsum of both hands and feet. The erythema began to develop 2~3 days after the 3rd~5th schedule of docetaxel chemotherapy and evolved to blister and desquamated over time. They didnt intake no other suspicious drug to induce cutaneous reactions and there was no symptom of herpes infection. Histopathological examination commonly revealed epidermal dysmaturation, vacuolar degeneration of basal layer, scattered necrotic keratinocytes and lymphohistiocytic infiltration in the upper dermis. Based on the recent medical history of docetaxel intravenous injection, the characteristic clinical features and histological findings, our three cases were all diagnosed with docetaxel-induced acral erythema. The skin lesion resolved with residual brownish discoloration after 2 weeks treatment with topical steroid.