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, L
Investigation
;
Hansel, K
Conceptualization
;
Pelliccia, S
Investigation
;
Tramontana, M
Investigation
;
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.
2018
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11391/1423317
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