Flexural erythematous eruption following autologous peripheral blood stem cell transplantation: a study of four cases

Autologous bone marrow transplantation and autologous peripheral blood stem cell transplantation (APBSCT) are alternative therapeutic options in the t reatment of various malignancies. We describe four patients undergoing APBS CT for malignancies; they developed a cutaneous eruption characterized by c onfluent erythematous and hyperpigmented patches within the flexural areas during the first month after transplantation. The lesions were poorly circu mscribed without epidermal changes such as scaling, xerosis, erosions or at rophy. The skin patches were treated with topical corticosteroids and resol ved within a few days with discoloration. Histopathological findings were c haracterized by focal vacuolar degeneration of the basal layer with epiderm al dysmaturation. We believe that these cutaneous eruptions are consistent with an interplay of high-dose chemotherapy and local factors such as frict ion, local slain temperature and eccrine gland distribution, which could ex plain the constant location of this eruption in the axillae and genital are a.