Korean J Hematol.  2007 Sep;42(3):292-295. 10.5045/kjh.2007.42.3.292.

A Case of High Dose Cytosine Arabinoside Induced Stevens-Johnson Syndrome in a Patient with Malignant Lymphoma

• An JW
• Lee MA
• Ko YH
• Nam SM
• Chung MK
• Moon SJ
• Kang JH
• Hong YS
• Lee KS

• KMID: 2305206
• DOI: http://doi.org/10.5045/kjh.2007.42.3.292

Abstract

Many chemotherapeutic agents induce variable cutaneous adverse reactions. Among the side effects, Stevens-Johnson syndrome is rare, but a fatal complication. There are two prior reports of cytosine arabinoside (ARA-C) induced toxic epidermal necrolysis, which is considered in the continuum of Stevens- Johnson syndrome. The prior cases were female patients under 16 years old with acute lymphocytic leukemia. We treated a 77-year-old man with recurrent mantle cell lymphoma who developed Stevens- Johnson syndrome after high dose ARA-C therapy. This is the first case of ARA-C induced Stevens- Johnson syndrome in Korea.

Keyword

Stevens-Johnson syndrome; Cytosine arabinoside; Lymphoma

MeSH Terms

Adolescent
Aged
Cytarabine*
Cytosine*
Female
Humans
Korea
Lymphoma*
Lymphoma, Mantle-Cell
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Stevens-Johnson Syndrome*
Cytarabine
Cytosine

Figure

• 

  Fig. 1 Erythematous skin lesion with multiple petechia was showen in the patient's back. Single vesicle was also noted.

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  Fig. 2 (A) The epidermis of skin biopsy shows subepidermal blister formation with scattered apoptotic keratinocytes (H&E ×100). (B) The dermis of skin biopsy shows mild perivascular lymphohistocytic infiltration with mild erythrocyte extravasation (H&E, ×200).

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  Fig. 3 Skin lesion including erythematous change with multiple petechia extended to the patient's face.

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  Fig. 4 After the treatment with IV steroid, skin lesion of the lower extremities was desquamated and improved.

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