A case of widespread erythema multiforme-like eruption and focal pustules on upper limbs is reported in a patient affected by chronic lymphocytic leukemia treated with oral chlorambucil. Skin biopsy revealed eczematous findings. Patch test with chlorambucil was positive on D4 (++) and it was biopsied confirming the same eczematous findings of lesional skin. The immunohistochemical study on patch test showed CD8+ lymphocytes, high expression of perforin, granzyme B (GrB), and fatty acid synthase ligand (FASL), typical of IVc hypersensitivity reaction. Our report underlines the high specificity of a patch test in systemic delayed reactions.
Systemic delayed hypersensitivity reaction to chlorambucil: a case report and literature review
Bianchi, LInvestigation
;Hansel, KConceptualization
;Pelliccia, SInvestigation
;Tramontana, MInvestigation
;Stingeni, L
Conceptualization
2018
Abstract
A case of widespread erythema multiforme-like eruption and focal pustules on upper limbs is reported in a patient affected by chronic lymphocytic leukemia treated with oral chlorambucil. Skin biopsy revealed eczematous findings. Patch test with chlorambucil was positive on D4 (++) and it was biopsied confirming the same eczematous findings of lesional skin. The immunohistochemical study on patch test showed CD8+ lymphocytes, high expression of perforin, granzyme B (GrB), and fatty acid synthase ligand (FASL), typical of IVc hypersensitivity reaction. Our report underlines the high specificity of a patch test in systemic delayed reactions.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.