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2007:73:1;63-64
doi: 10.4103/0378-6323.30662
PMID: 17314457

Urticarial papules and plaques on the trunk

Tarun Narang1 , Amrinder Jit Kanwar1 , Sunil Dogra1 , Bishan Dass Radotra2
1 Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Amrinder Jit Kanwar
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India
How to cite this article:
Narang T, Kanwar AJ, Dogra S, Radotra BD. Urticarial papules and plaques on the trunk. Indian J Dermatol Venereol Leprol 2007;73:63-64
Copyright: (C)2007 Indian Journal of Dermatology, Venereology, and Leprology
Histopathology showing a neutrophilic infiltrate around the sweat glands and degeneration of eccrine glands (H and E stain (a) 100x; (b) 1000x)
Histopathology showing a neutrophilic infiltrate around the sweat glands and degeneration of eccrine glands (H and E stain (a) 100x; (b) 1000x)
Erythematous plaques on the trunk and upper extremities of the patient after cyclophosphamide
Erythematous plaques on the trunk and upper extremities of the patient after cyclophosphamide

A 65-year-old female was being treated with cyclophosphamide for follicular dendritic cell tumor of the cervical lymph nodes. She presented to us with erythematous painful eruption on the extremities and trunk that started approximately one week after starting the chemotherapy. She had been treated with chlorpheniramine followed by a course of prednisolone 30 mg OD for one week. This caused resolution of the lesions, but they recurred after the corticosteroids were stopped. The patient was otherwise fit and well with no other symptoms. She was on no other medication. Examination revealed numerous tender, erythematous and edematous papules and plaques on her trunk and proximal parts of extremities [Figure - 1]a and b. Her palms and soles were spared.

Complete blood count, renal and liver function tests, electrolytes and autoantibody screen were normal with the exception of an elevated neutrophil count (12.10 x 109/L). Skin biopsy taken from one of the lesions showed a polymorphous inflammatory reaction within and around some eccrine sweat ducts, consisting of many neutrophils and a few lymphocytes without red blood cells extravasation [Figure - 2]. Special stains with Perls and Rouge Congo were negative. Acid-fast bacilli, periodic acid-Schiff and Gomori methenamine silver stains and a tissue culture were all negative for infection. Cyclophosphamide was stopped and over the course of the next week, the eruption gradually resolved without any other intervention.

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