CHEMOTHERAPY-INDUCED ECCRINE SQUAMOUS SYRINGOMETAPLASIA - A DISTINCTIVE ERUPTION IN PATIENTS RECEIVING HEMATOPOIETIC PROGENITOR CELLS

Background: Eccrine squamous syringometaplasia (ESS) has been associat ed with a characteristic clinical eruption in patients receiving chemo therapy. It has been suggested as a diagnostic clue in the diagnosis o f chemotherapy-induced reactions vs acute graft-vs-host disease, as we ll as other drug reactions. We identified 10 cases of ESS in patients in whom a distinctive clinical eruption developed during or after a pr etransplantation conditioning regimen with high-dose chemotherapy. A c omplete clinical and histologic evaluation was performed in all patien ts. Observations: All patients developed erythematous and edematous pl aques or confluent erythematous macular areas in the axillae and/or gr oin, with painful areas of well-defined erythema and edema on palms an d/or soles in 5 patients. Some discrete papular lesions on the trunk o r extremities could also be observed in most patients. The histologic hallmark of the eruption was ESS, with a variable degree of cornificat ion and apoptosis. A vacuolar interface dermatitis and a variable degr ee of cellular atypica were also consistent findings. Conclusions: Che motherapy-induced ESS may be associated with a distinctive clinical er uption and should be considered in the differential diagnosis of eryth ematous eruptions during or after a pretransplantation conditioning re gimen with high-dose chemotherapy.