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Published on: June 10, 2025
Bullous variant of acral erythema due to methotrexate
Sheela Kuruvila1, Monica Dalal, B Sivanesan
1Department of Dermatology, Pondicherry Institute of Medical Sciences, Pondicherry, India. skuruvila@gmail.com
Abstract:
Chemotherapy-induced acral erythema is a painful erythema of the palms and soles which occurs following chemotherapy. It is usually seen due to cytarabine, doxorubicin and fluorouracil. We present a 40-year-old male patient, a biopsy proven case of squamous cell carcinoma of the floor of the mouth, who developed a bullous variant of acral erythema after a single intravenous dose of methotrexate. He also had fever, buccal mucositis, leucopenia, thrombocytopenia and hyperpigmented macular rash on the face and upper trunk. The bullous variant of acral erythema due to methotrexate has rarely been reported.
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