Mucocutaneous reactions to antineoplastic agents

Mucocutaneous reaction patterns in patients receiving cancer therapy are not only variable, but in many instances identical patterns are produced by different pathologic mechanisms. For example, patients with leukemia or lymphoma may present with nodular skin lesions that may represent malignant infiltration, septic emboli, vasculitis, or a drug eruption. The most banal skin eruption may signal an impending or ongoing catastrophe. If one is able to make some clinical evaluation regarding the likelihood of a drug being responsible for the mucocutaneous eruption, it may help avoid further clinical or laboratory investigation and patient discomfort. Unfortunately, only a few antineoplastic agents have "characteristic" skin manifestations. If, however, these are kept in mind they may be helpful in the diffential diagnosis of mucocutaneous eruptions occurring in patients treated with cancer chemotherapeutic agents.