Journal of Clinical Oncology, Vol 12, 1703-1709, Copyright © 1994 by American Society of Clinical Oncology
Transient acantholytic dermatosis in oncology patients
AL Guana and PR Cohen
Universidad Javeriana, Bogota, Columbia.
PURPOSE: To evaluate the characteristics of patients with cancer who have a
previous history, concurrent episode, or subsequent appearance of transient
acantholytic dermatosis (TAD). METHODS: We report four oncology patients
who developed TAD and review the 22 reports that have previously been
published of individuals in whom TAD appeared either before, concomitant
with, or after the diagnosis of their malignancy. RESULTS: TAD was
associated more frequently in patients with hematologic malignancies,
especially acute and chronic myelogenous leukemia. It also appeared in
patients with solid tumors, primarily those of the genitourinary organs. In
almost all the cases, the onset of TAD was either concurrent or followed
the discovery of malignancy. The TAD resolved completely, with or without
treatment, in at least 20 patients in a median of 3 weeks. CONCLUSION: TAD
is a benign and temporary condition that may occur in patients with an
internal malignancy. When the diagnosis of TAD is being considered, a
lesional skin biopsy readily establishes histologic confirmation in a
febrile patient with cancer who develops a new rash. TAD has been observed
most frequently in oncology patients who have either myelogenous leukemia
or carcinoma of the genitourinary organs. The appearance of TAD coincided
with either the detection or the recurrence of malignancy in three
individuals (12%). In the other 23 oncology patients, TAD was most likely
secondary to either antineoplastic agents, excessive perspiration, fever,
occlusive immobility, and/or ionizing or UV radiation.
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