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Dermatitis due to intravesical mitomycin C: a delayed-type hypersensitivity reaction?
G B Colver1, J A Inglis, E McVittie
1University Department of Dermatology, Royal Infirmary, Edinburgh.
The British Journal of Dermatology
|February 1, 1990
Summary
Mitomycin C instillations can cause skin reactions like eczematous eruptions. These reactions are likely hypersensitivity responses, possibly mediated through the bladder wall, as indicated by patch tests and immune cell presence.
Area of Science:
- Immunology
- Dermatology
- Urology
Background:
- Mitomycin C is an alkylating agent used for bladder carcinoma.
- Repeated intravesical instillations can lead to cystitis and eczematous eruptions on the skin.
- The hypothesis suggests these skin reactions result from delayed hypersensitivity to Mitomycin C.
Purpose of the Study:
- To investigate if eczematous eruptions from Mitomycin C are a hypersensitivity reaction.
- To identify antigen-presenting cells in the bladder wall of affected patients.
- To confirm sensitization through patch testing.
Main Methods:
- Immuno-alkaline phosphatase staining to identify CD1+ cells in bladder tissue.
- Electron microscopy to detect Birbeck granules.
- Dermal patch testing with Mitomycin C in patients.
Main Results:
- CD1+ antigen-presenting cells were found in the bladder epithelium and submucosa.
- Birbeck granules were observed in some bladder cells.
- Delayed hypersensitivity was demonstrated in 13 of 26 patients via positive patch tests.
Conclusions:
- The eczematous eruption associated with Mitomycin C is likely a hypersensitivity reaction.
- Sensitization to Mitomycin C may occur in the bladder wall.
- The reaction might be transvesically mediated.