tretinoin and Erythema-Nodosum

A 24-year-old woman with acute promyelocytic leukemia was treated with all-trans retinoic acid (ATRA) as a remission induction therapy. After pneumonia in the neutropenic period was successfully treated with antibiotic treatment, there was recurrence of high fever alone, followed by the appearance of erythema nodosum with pain in her upper limbs on day 25 of ATRA therapy. Skin biopsy neither revealed infiltration of leukemic cells nor suggested Sweet's syndrome. We considered the eruptions to be associated with ATRA, and prednisolone (30 mg/day for 5 days) was administered. Although the administration of ATRA was continued until complete remission of the leukemia, the erythema nodosum rapidly disappeared following short-term steroid therapy and no recurrence was observed. ATRA-induced erythema nodosum is rare, however it should be recognized as a possible adverse effect in ATRA therapy.

Topics: Adult; Antineoplastic Agents; Erythema Nodosum; Female; Fever; Humans; Leukemia, Promyelocytic, Acute; Prednisolone; Recurrence; Remission Induction; Treatment Outcome; Tretinoin

Erythema nodosum associated with all- trans-retinoic acid (ATRA) for acute promyelocytic leukemia (APL) is very rare. We describe four patients with classic APL who developed erythema nodosum during ATRA therapy. Fever and subsequent multiple painful erythematous nodules over extremities developed on D11, D16, D17, and D19, respectively, after ATRA therapy. The skin biopsy taken from each patient was consistent with erythema nodosum. All patients received short course of steroids. Fever subsided rapidly and the skin lesions regressed completely. All patients achieved complete remission without withdrawal of ATRA. ATRA seemed to be the most possible etiology of erythema nodosum in our patients. Short-term use of steroid is very effective in ATRA-induced erythema nodosum.

Topics: Adult; Antineoplastic Agents; Erythema Nodosum; Female; Humans; Leukemia, Promyelocytic, Acute; Male; Prednisolone; Treatment Outcome; Tretinoin

A patient with acute promyelocytic leukemia is presented. During treatment with all-trans-retinoic acid, erythema nodosum developed. Treatment with all-trans-retinoic acid was continued, the erythema nodosum resolved with steroid treatment, and a complete remission was attained. This case is the first report of erythema nodosum associated with all-trans-retinoic acid.

Topics: Adult; Erythema Nodosum; Female; Humans; Leukemia, Promyelocytic, Acute; Tretinoin

Topics: Acne Vulgaris; Adolescent; Adult; Antigen-Antibody Complex; Erythema Nodosum; Humans; Isotretinoin; Male; Tretinoin