melphalan and Foot-Dermatoses

We describe the previously unreported use of isolated limb infusion (ILI) to treat extensive, bilateral plantar warts in a 54-year-old female. The warts had covered the weight-bearing surfaces of both feet for 10 years and had failed to respond to all previous treatments.. A standard ILI technique was used to infuse melphalan and actinomycin D to the left leg. Circulation was maintained for 30 min. The limb was warmed and upon completion of the procedure was markedly hypoxic and acidotic. The contralateral limb was treated 6 months later.. At 5 weeks, a partial response with 80% disease clearance was observed. Pain impeded mobilisation until desquamation occurred 6 weeks postoperatively. There was little regrowth at 6 months.. Although invasive, ILI may represent a viable treatment option for resistant human papilloma virus-induced warts on the peripheries. Further research into this potential treatment tool is warranted.

Topics: Cytotoxins; Dactinomycin; Drug Therapy, Combination; Female; Foot Dermatoses; Humans; Infusions, Intra-Arterial; Infusions, Intravenous; Infusions, Parenteral; Melphalan; Middle Aged; Papillomavirus Infections; Warts

Topics: Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Carmustine; Cytarabine; Drug Hypersensitivity; Female; Fibroblast Growth Factor 7; Foot Dermatoses; Hand Dermatoses; Humans; Lymphoma, B-Cell; Melphalan; Middle Aged; Mitogens; Podophyllotoxin

Early skin reactions on mouse feet and delay in growth of a mouse tumor (CA NT) were measured after combined treatments with X-rays and the cytotoxic drug Melphalan. The drug was given as a single dose (10 mg kg-1) with graded single doses of X-rays, either before or after irradiation with an interval of up to 4 days. In the mouse skin, addition of the drug increased the radiation response only slightly. The maximum Enhancement Ratio (ER) measured at a skin reaction of 1.5 (approximately 23 Gy) was 1.07 +/- 0.02 SEM for the schedule MEL 3 days before X-rays. ER's for all schedules tested were similar with a range of 1.00 to 1.07. For the tumor more enhancement was observed; the largest ER's were found when Melphalan was given before rather than after irradiation, with maximum ER's of 2.3 and 2.4 when the drug was given 3 days or 1 day before X-rays. This has been attributed to reoxygenation of hypoxic cells after drug treatment, rendering the tumor more radiosensitive. The range of ER over all schedules was 1.5-2.4. Since ER is greater for the tumor than skin for all schedules, a therapeutic advantage is indicated under these specific experimental conditions of single X-ray and drug doses.

Topics: Animals; Combined Modality Therapy; Dose-Response Relationship, Radiation; Erythema; Foot Dermatoses; Male; Melphalan; Mice; Mice, Inbred CBA; Mice, Inbred Strains; Neoplasms, Experimental; Radiation Injuries, Experimental; Radiation-Sensitizing Agents; Skin; Time Factors