Korean J Gastroenterol.  2023 Apr;81(4):173-177. 10.4166/kjg.2023.030.

First Case of Atypical, Generalized Skin Rash after Transarterial Chemoembolization in a Patient with Hepatocellular Carcinoma

• Lee Y
• Cho E
• Park CH
• Yoon JH
• Choi SK
• Kim HO
• Park C
• Yun SJ

• KMID: 2541780
• DOI: http://doi.org/10.4166/kjg.2023.030

Abstract

Transarterial chemoembolization (TACE) is a widely used hepatocellular carcinoma (HCC) treatment. Some cases of supraumbilical skin rash after TACE in patients with HCC have been reported. To the best of the authors’ knowledge, there are no reports on atypical, generalized rashes caused by doxorubicin systemic absorption after TACE. This paper presents the case of a 64-year-old male with HCC who developed generalized macules and patches one day after a successful TACE procedure. A histology examination of a skin biopsy of a dark reddish patch on the knee revealed severe interface dermatitis. He was treated with a topical steroid, and all skin rashes improved within a week with no side effects. This report presents this rare case with a literature review on skin rash after TACE.

Keyword

Carcinoma; hepatocellular; Drug-related side effects and adverse reactions; Exanthema; Chemoembolization; therapeutic

Figure

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  Fig. 1 Dynamic magnetic resonance imaging showing (A) enhancement of the mass (arrow) in the arterial phase and (B) wash-out of the mass (arrow) in the hepatobiliary phase.

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  Fig. 2 Angiography of the patient. (A) A selective right hepatic arteriography reveals hypervascular tumoral staining in the right hepatic lobe. (B) Postembolization C-arm CT showed a compact lipiodol uptake lesion in the right hepatic lobe.

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  Fig. 3 Asymptomatic purpuric macules and patches of varying sizes were distributed on the trunk and limbs. Petechiae-like rashes appeared mainly on the back and extremities (A). On the other hand, maculopapular rashes were observed on the left thigh and around the knee (B, C).

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  Fig. 4 Multiple apoptotic bodies with full-thickness epidermal necrosis, subepidermal blister formation, and mild perivascular lymphocytic infiltration (H&E stain, 200×).

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