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A generalized cutaneous reaction induced by granulocyte colony-stimulating factor
L F Glass1, T Fotopoulos, J L Messina
1Department of Medicine, University of South Florida College of Medicine, Tampa, USA.
Journal of the American Academy of Dermatology
|March 1, 1996
Summary
Cutaneous reactions to granulocyte colony-stimulating factor (GCSF) present unique clinical and histologic features in bone marrow transplant patients. These characteristic findings help distinguish GCSF-induced eruptions from other post-transplant skin conditions.
Area of Science:
- Hematology
- Dermatology
- Oncology
Background:
- Recombinant granulocyte colony-stimulating factors (G-CSF) and granulocyte-macrophage colony-stimulating factors (GM-CSF) are increasingly used for neutropenia.
- Reports of cutaneous reactions associated with G-CSF and GM-CSF use are rising.
Observation:
- Three bone marrow transplant patients developed a cutaneous eruption during G-CSF therapy.
- The eruption manifested as indurated, well-demarcated, erythematous desquamation after medication withdrawal.
Findings:
- Histological examination revealed mild epidermal spongiosis and a dermal infiltrate of enlarged macrophages.
- Increased expression of ELAM-1, VCAM-1, and ICAM-1 was observed in affected skin.
- The observed clinical and histological features are characteristic of G-CSF-induced cutaneous reactions.
Implications:
- The distinct clinical and histological profile aids in differentiating G-CSF reactions from other eruptions in bone marrow transplant recipients.
- Understanding these reactions is crucial for managing side effects in patients undergoing transplantation.