Antineoplastics
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Reactions 1022 - 9 Oct 2004 ★ S Antineoplastics Atypical chickenpox (first report with bleomycin, doxorubicin and vincristine): case report A 35-year-old woman developed atypical chickenpox, with a distribution similar to that of hand-foot-and-mouth disease, during antineoplastic therapy for non-Hodgkin’s lymphoma. The woman, who had a childhood history of chickenpox, presented with a vesicular eruption on her tongue, palms and soles during treatment with methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisolone and bleomycin [dosages and duration of treatment not stated]. One week later, she developed a fever and her skin eruption worsened, with enlargement of the vesicles on her palms and soles and dissemination to her entire body. She also developed multiple umbilicated vesicles and bullae on her face trunk and extremities. A lesional biopsy showed reticular and ballooning degeneration of the epidermis with multinucleated giant cells, and intranuclear inclusion bodies in the keratinocytes. PCR analysis of a blood sample revealed Varicella zoster virus DNA. In addition, her AST and ALT levels increased to 130 and 242 U/L, respectively. The woman was treated with aciclovir and her symptoms improved, with resolution of her skin eruption within 2 weeks. Author comment: "We speculate that chemotherapy induced damage of the acral skin and oral mucosa might be involved in the unusual distribution of the vesicular eruption." Osawa M, et al. Atypical varicella mimicking hand-foot-mouth disease in an adult patient with malignant lymphoma during chemotherapy. British Journal of Dermatology 151: 254-256, No. 1, Jul 2004 - Japan 800987851 » Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of chickenpox associated with bleomycin, doxorubicin or vincristine. The WHO Adverse Drug Reactions database contained one report of varicella associated with bleomycin and one report of varicella associated with doxorubicin, but no reports of varicella associated with vincristine. 1 Reactions 9 Oct 2004 No. 1022 0114-9954/10/1022-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1022 - 9 Oct 2004
★ SAntineoplastics
Atypical chickenpox (first report with bleomycin,doxorubicin and vincristine): case report
A 35-year-old woman developed atypical chickenpox, with adistribution similar to that of hand-foot-and-mouth disease,during antineoplastic therapy for non-Hodgkin’s lymphoma.
The woman, who had a childhood history of chickenpox,presented with a vesicular eruption on her tongue, palms andsoles during treatment with methotrexate, doxorubicin,cyclophosphamide, vincristine, prednisolone and bleomycin[dosages and duration of treatment not stated]. One weeklater, she developed a fever and her skin eruption worsened,with enlargement of the vesicles on her palms and soles anddissemination to her entire body. She also developed multipleumbilicated vesicles and bullae on her face trunk andextremities. A lesional biopsy showed reticular and ballooningdegeneration of the epidermis with multinucleated giant cells,and intranuclear inclusion bodies in the keratinocytes. PCRanalysis of a blood sample revealed Varicella zoster virus DNA.In addition, her AST and ALT levels increased to 130 and242 U/L, respectively.
The woman was treated with aciclovir and her symptomsimproved, with resolution of her skin eruption within 2 weeks.
Author comment: "We speculate that chemotherapyinduced damage of the acral skin and oral mucosa might beinvolved in the unusual distribution of the vesicular eruption."Osawa M, et al. Atypical varicella mimicking hand-foot-mouth disease in an adultpatient with malignant lymphoma during chemotherapy. British Journal ofDermatology 151: 254-256, No. 1, Jul 2004 - Japan 800987851
» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of chickenpox associatedwith bleomycin, doxorubicin or vincristine. The WHO AdverseDrug Reactions database contained one report of varicellaassociated with bleomycin and one report of varicella associatedwith doxorubicin, but no reports of varicella associated withvincristine.
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Reactions 9 Oct 2004 No. 10220114-9954/10/1022-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
