Dermal infiltrate of enlarged macrophages in patients receiving chemotherapy

A histologically distinct maculopapular eruption has been associated with the use of recombinant forms of granulocyte and granulocyte-macrophage colony-stimulating factors (GCSF and GMCSF). One of the most distinctive features was an increase in the number and the size of dermal macrophages, which was proposed as a clue to diagnosis of these cytokine-induced dermatoses. We describe 8 patients who received chemotherapy and who developed a maculopapular eruption, of which histological examination showed an increase in the number and the size of dermal macrophages. Three patients had also received GM-CSF or G-CSF, before the onset of rash, but 5 patients had not. In conclusion, an increase in the number and the size of dermal macrophages is not specific for the reaction to GM-CSF or G-CSF, and may also be observed in patients receiving chemotherapy.