Chemotherapy-induced acral erythema (CIAE) with bullous reaction

Chemotherapy-induced acral erythema (CIAE) is a cutaneous response to a num ber of different chemotherapeutic agents. It causes a symmetrical, painful erythema of both the palms and soles which is self-limiting. CIAE with bull ous reaction has been reported in relation to methotrexate, but it has been more commonly associated with cytosine arabinoside. We describe a case of CIAE with bullous reaction in a patient treated for Hodgkin's disease with a number of chemotherapeutic agents. We discuss the differential diagnosis of this condition which includes eccrine squamous syringometaplasia and acu te graft vs. host disease.