Hand-foot syndrome, also known as acral erythema, is a distinctive and relatively common toxic reaction due to some anticancer drugs. It is characterized by a painful erythema on the palms and soles during chemotherapy, which is often preceeded by paresthesia. We report two cases of hand-foot syndrome induced by capecitabine, which is a relatively brand-new oral anticancer agent. Hand-foot syndrome is one of the most common complications of capecitabine, and is on the increase. Therefore, dermatologists should be aware of it.
Drug Therapy ; Erythema ; Hand-Foot Syndrome* ; Paresthesia ; Capecitabine

Lyme disease is a vector-borne infection, primarily transmitted by Ixodes ticks, and caused by Borrelia burgdorferi. It has a wide distribution in the northern hemisphere. In Korea, however, only one human case has been reported, although B. burgdorferi was isolated from the vector tick I. persulcatus in the region. A 60-year-old male and a 45-year-old female developed the clinical sign of erythema migrans. Each patients were bitten by a tick four weeks and five weeks, respectively, before entering the hospital. On serologic examination, significantly increased IgM and IgG antibody titers to B. burgdorferi were observed in consecutive tests performed at an interval of two weeks. They responded well to treatment with tetracycline.
Case Report ; Erythema Chronicum Migrans/pathology* ; Erythema Chronicum Migrans/immunology ; Erythema Chronicum Migrans/drug therapy ; Female ; Human ; Korea ; Lyme Disease/pathology* ; Lyme Disease/immunology ; Lyme Disease/drug therapy ; Male ; Middle Age

Attention has been paid to the thiocarbanilide derivative and the authors synthesized some new compounds of thiocarbanilides for experimental studies on tuberculosis and leprosy. The series of newly synthesized chemical compounds of thiocarbanilides were studied for comparision with the already known antimycobacterial agents; INH, PAS, Streptomycin and D. D. S. The strains of Mycobacterium tubercubsis (H37 Rv, Ravenel, and B. C. G.) and Mycobacterium phlei were used for the in vitro experiments. In the in vivo experiments, the strain of Mycobacterium tuberculosis var. bovis (Ravenel) was employed. The strain of Mycobacterium leprae murium (Hawaiian strain) was used for the murine leprosy experiments. The experimental animals for the in vivo tests were white mice (CFW strain) and these were extensively employed in tuberculosis and leprosy as well. Sixteen cases of Various types of human leprosy, were treated with one of the newly synthesized thiocarbanilides (L-4). Among the newly synthesized chemical compounds of thiocarbanilides studied for their antituberculous and antimurine leprosy activity in vitro and in vivo experiments, two compounds were shown to be suppressive agents for those infections without significant toxicity. These two compounds were named tentatively as L-1 and L-4. 1) LD50 of L-1 was 1,054 mg/kg and that of L-4 was 1,028 mg/kg, while the LD50 of INH was 650 mg/kg and PAS was 4,000mg/kg orally in the experimental animals. 2) L-1 and L-4 showed remarkable suppressive activity in vitro using solid media with 100r/ml. concentration. These data were parallel to 1r/ml. of INH and 50r/ml. of PAS. The inferiority of L-1 and L-4 to INH and PAS in vitro studies might have been due to the water insolubility of these compounds while INH and PAS were readily soluble in water. 3) In vivo experiments with L-1 showed a much-more superior antituberculous effect than was found with INH and PAS. 4) A method of grading the bacterial count in a homogenized tissue suspension of visceral organs (lungs, liver, spleen and kidneys) using the simple technique of the Gaffky scale was accurate and time saving technique in screening the results of the chemotherapeutic agents in tuberculosis. 5) Among the newly synthesized compounds L-4 showed the most remarkable suppressive effect on murine leprosy. The suppressive results were similar to those of INH. 6) The method of measuring the size and the weight of leproma at the inoculated site was simple and is an adequate screening test for chemotherapeutic effect in murine leprosy. 7) In the trials with human leprosy 16 cases of various types, using L-4, the effectiveness in clinical as well as in bacteriological improvement was remarkable. a) After L-4 treatment decrease in bactriologica1 indices and remarkable clinical improvement after a relative1y short period of treatment were observed. b) L-4, up to the maximum daily dose of 500 mg, can be safely administered orally to the patients without any significant side reactions. c) L-4 could be used with remarkable clinical improvement for the patients in lepra reactions.
Adult ; Animals ; Comparative Study ; Erythema Nodosum/drug therapy ; Female ; Human ; Leprosy/*drug therapy ; Male ; Mice ; Thiourea/*therapeutic use

A 12-year-old boy showed a slatecolored scaly patch on h; ight face for 2 months. Histopathologic findings showed basal vacuolations and dermal me arphages with only scanty lymphoid cells in the fat tissue layer. Besides the facial lesion, lesions of edematous localized erythema were noted on his right if and left buttock with similar mi rocopical findings. 6 months later the facial lesion was aggravated like a cellulitis, of which thc bevpsy findings were consistent with mycosis fungoides. The patient received chemotherapy aftei the diagonsis for one month before his termination. Because of the rarity of mycosis fungoides in childhood age and its un common cutaneous lesions, the case is reported.
Buttocks ; Cellulitis ; Child ; Dronabinol ; Drug Therapy ; Erythema ; Humans ; Lymphocytes ; Male ; Mycosis Fungoides* ; United Nations

Radiation recall dermatitis is the development of an inflammatory reaction throughout an area previously irradiated, precipitated by the administration of certain drugs. A 48-year-old woman was postoperatively treated with radiotherapy for synovial sarcoma on her left hip. The total dose given was 46 Gy by 2 Gy per day. After 2 weeks, she underwent her 1st cyclophosphamide, dacarbazine, doxorubicin (MAID) chemotherapy teatment. After 3 days, erythema began to develop in the previously irradiated area and during the following 7 days a severe skin and subcutaneous reaction occurred. After 3 weeks, the skin lesion was completely healed and thereafter no further "recall" occurred despite a 2nd MAID chemotherapy treatment.
Cyclophosphamide ; Dacarbazine ; Doxorubicin ; Drug Therapy ; Erythema ; Female ; Hip ; Humans ; Middle Aged ; Radiodermatitis* ; Radiotherapy ; Sarcoma, Synovial ; Skin

A radiation recall reaction refers to an inflammatory reaction at previous irradiated areas subsequent to the administration of a variety of pharmacological agents. The skin is the major site of radiation recall reactons with the muscle and internal organs being less commonly affected. These reactions usually occur days to weeks after exposure to the causative agents. We report a case of gemcitabine-induced radiation recall dermato-myositis the developed in a female patient with a metastatic non-small cell lung cancer. She had received a palliative radiation therapy of 3900 cGy to the metastatic lesion on the femur shaft prior to chemotherapy. The pain, swelling and erythema of the left thigh resolved after the cessation of gemcitabine and the use of a systemic steroid.
Carcinoma, Non-Small-Cell Lung ; Drug Therapy ; Erythema ; Female ; Femur ; Humans ; Lung Neoplasms ; Radiodermatitis ; Skin ; Thigh

Bleomycin, an antitumor antibiotic, has several dose-related skin toxicities, including hyperpigmentation, sclerosis, gangrenes, nail changes, and erythema in certain selected skin sites. A case of hyperpigmentation in a linear pattern due to in tavenous injection of bleomycin in a 37-year-old man with squamous cell carcinoma at nasopharynx is described. After 9 months since bleomycin chemotherapy started, dark brownish colored linear hyperpigmentation developed along veins of the skin of both arms.
Adult ; Arm ; Bleomycin* ; Carcinoma, Squamous Cell ; Drug Therapy ; Erythema ; Gangrene ; Humans ; Hyperpigmentation* ; Nasopharynx ; Sclerosis ; Skin ; Veins

Rosacea is a common chronic cutaneous disorder that primarily occurs on the convex surfaces of the central face and is often characterized by exacerbations and remissions. A case of a 52-yr-old woman visited our clinic in February 2008 complaining typical features of rosacea including multiple pinhead to rice-sized erythematous papules. We applied various conventional treatments including topical benzoyl peroxide and metronidazole as well as oral metronidazole, isotretinoin, and doxycycline. The lesions were not controlled but were rather aggravated by complications from these treatments. Therefore, we prescribed oral azithromycin, which has anti-inflammatory effects and reduces reactive oxygen species. Ten weeks after the administration of oral azithromycin, 500 mg per day for 2 weeks, the lesions had mostly disappeared and no specific side effects related to the azithromycin were noted. Oral azithromycin dosing 500 mg/day for 2 weeks is effective for treatment of intractable rosacea.
Administration, Oral ; Azithromycin/administration & dosage/pharmacology/*therapeutic use ; Erythema/diagnosis/drug therapy ; Female ; Humans ; Middle Aged ; Reactive Oxygen Species ; Rosacea/diagnosis/*drug therapy ; Skin Diseases/drug therapy

Bleomycin is an antitumoral antibiotic derived from Streptomyces verticillus in 1965. The drug has been used with a varying success in the treatment of squamous cell carcinomas and malignant lymphomas. The cutaneous toxicities of bleomycin include hyperpigmentation, sclerosis, gangrene, nail changes and erythema. Linear streaks appear to be a characteristic eruption induced by bleomycin. We report three cases of flagellate pigmentation from intravenous bleomycin. Three patients were suffering from uterine cervical carcinomas and were treated with chemotherapy with a VBP (vincristine, bleomycin, cisplatire) regimen. During or after their courses of chemotherapy, dark brownish skin lesions developed on the body surface of these patients. A Light microscopic study of each specimen showed increased pigmentation of the basal layer and an electron microscopic study showed a slightly increased number of melanosomes in keratinocytes.
Bleomycin* ; Carcinoma, Squamous Cell ; Drug Therapy ; Erythema ; Gangrene ; Humans ; Hyperpigmentation ; Keratinocytes ; Lymphoma ; Melanosomes ; Pigmentation* ; Sclerosis ; Skin ; Streptomyces

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.
Appointments and Schedules ; Blister ; Dermis ; Drug Therapy ; Erythema* ; Foot ; Hand ; Hand-Foot Syndrome ; Humans ; Injections, Intravenous ; Keratinocytes ; Lung ; Ovarian Neoplasms ; Skin