CYTOSINE ARABINOSIDE-INDUCED VASCULITIS

Dermatologic side effects of cytosine arabinoside (ara-C) are rare and most commonly occur after high-dose (more than 100 to 200 mg/m(2) per day) therapy has been administered for several days, Although vascula r reactions after combination chemotherapeutic regimens with ara-C hav e been anecdotally described, they have not been previously reported a fter single-agent chemotherapy with ara-C. Herein we describe two pati ents with acute nonlymphoblastic leukemia in whom cutaneous small vess el necrotizing vasculitis developed after high-dose single-agent chemo therapy with ara-C, Cutaneous lesions developed 3 to 5 days after init iation of therapy and resolved spontaneously within a week after the c hemotherapeutic regimen was completed, No evidence of systemic vasculi tis was present in either patient, Prior experimental data have demons trated a direct toxic effect of ara-C on endothelial cells, and this o utcome may represent the underlying mechanism of vascular injury.