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Chemotherapy‐induced acral erythema: report of a case and immunohistochemical findings
Author(s) -
Tsuruta D.,
Mochida K.,
Hamada T.,
Ishii M.,
Wakasa K.,
Hashimoto S.,
Takekawa K. E.
Publication year - 2000
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1046/j.1365-2230.2000.00670.x
Subject(s) - pathology , immunohistochemistry , peripheral blood mononuclear cell , mononuclear cell infiltration , medicine , infiltration (hvac) , pathogenesis , epidermis (zoology) , erythema , chemotherapy , dermis , cd3 , antigen , immunology , biology , cd8 , anatomy , biochemistry , physics , in vitro , thermodynamics
Chemotherapy‐induced acral erythema (CAE) is an uncommon and distinct reaction seen in patients receiving high‐dose chemotherapy. The exact pathogenic mechanisms of this disorder are still unknown. We report a 27‐year‐old woman who presented with red, swollen and painful macules on both palms, clinically consistent with this disease. Histological examination demonstrated vacuolar degeneration of the basal cell layer and spongiotic blisters in the epidermis, especially in the atrophied eccrine ducts and papillary oedema with mild perivascular infiltration of mononuclear and hypersegmented neutrophils. Immunohistochemistry showed that the infiltrating mononuclear cells were CD3–CD16+CD56+ leucocyte function antigen‐1+, possibly natural killer cells. The eccrine ducts expressed HLA‐DR and intracellular adhesion molecule‐1 (ICAM‐1). Our findings suggest that cell‐to‐cell interaction between NK cells and keratinocytes in the eccrine apparatus may induce CAE and may be involved in the pathogenesis of the skin reaction in our patient and possibly in this disease.