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Cytosine arabinoside-induced vasculitis
I Ahmed1, K R Chen, H Nakayama
1Department of Dermatology, Mayo Clinic Rochester, Minnesota, USA.
Mayo Clinic Proceedings
|March 25, 1998
Summary
Dermatologic side effects of cytosine arabinoside (ara-C) are rare. This study reports two cases of cutaneous small vessel necrotizing vasculitis following high-dose single-agent chemotherapy with ara-C in patients with acute nonlymphoblastic leukemia.
Area of Science:
- Oncology
- Dermatology
- Pharmacology
Background:
- Cytosine arabinoside (ara-C) is a chemotherapy agent.
- Dermatologic side effects of ara-C are uncommon, typically associated with high-dose or prolonged therapy.
- Vascular reactions are rarely reported with ara-C, and not previously with single-agent use.
Observation:
- Two patients with acute nonlymphoblastic leukemia developed skin lesions.
- Lesions appeared 3-5 days after high-dose single-agent ara-C chemotherapy.
- The cutaneous vasculitis resolved spontaneously within a week after treatment completion.
Findings:
- This is the first report of cutaneous small vessel necrotizing vasculitis after single-agent high-dose ara-C.
- No systemic vasculitis was observed in either patient.
- Experimental data suggest ara-C may directly injure endothelial cells.
Implications:
- High-dose single-agent ara-C can induce cutaneous small vessel necrotizing vasculitis.
- This adverse reaction appears to be transient and self-limiting.
- Understanding ara-C's endothelial toxicity is crucial for managing chemotherapy-induced dermatologic complications.