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Eruption of lymphocyte recovery


European Journal of Dermatology. Volume 9, Number 4, 323-4, June 1999, Votre diagnostic !

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Author(s) : Manuel Ginarte, Carmen Peteiro, Jaime Toribio

Summary : A 63 year-old man diagnosed with laryngeal squamous carcinoma (Stage IV, T3N2MO) was treated with fluorouracil, leucovorin, and cisplatin. Two weeks after the end of the fourth chemotherapy cycle, the patient presented an asymptomatic, symmetrical rash of erythematous infiltrated papules and plaques located on palms and back of the hands, wrists, and forearms (Fig. 1 and 2). The patient denied taking any drug and had not noticed fever or malaise. He had not been treated with cytokines. There was no lymphadenopathy. His white blood cell count at that time was 4,930/µL with 66% neutrophils, and 21% lymphocytes (2,360/µL with 47% neutrophils, and 33% lymphocytes at the end of the fourth chemotherapy cycle). A skin biopsy specimen was taken from a lesion, and the histological picture is shown in Figures 3 and 4. A spontaneous recovery after desquamation occured three weeks later. What is your diagnosis ?

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