Decitabine Induced Localized Maculopapular Eruption

Aims: Decitabine is a drug for the treatment of myelodysplastic syndromes and acute myeloid leukemia. It has a side-effect profile affecting many systems, including dermatologic side effects. Herein, we report a case with a maculopapular-type drug eruption due to decitabine.
Presentation of Case: A 51-year-old previously healthy woman was diagnosed with myelodysplastic syndrome RAEB-1, and decitabine [20mg/m2/day/i.v (5 days with cycles repeated every 28 days)] chemotherapy was given. On the seventh day of the second treatment cycle, we diagnosed a maculopapular eruption on the front of the left arm. The patient presented with skin that was itchy, puffy, maculopapular and erythematous. The rash faded when pressed and tended to coalesce with each other, indicating a drug eruption due to decitabine. Maculopapular type drug reaction depending on decitabine was considered. The eruption improved remarkably within 10 days, and the patient's rash had disappeared by the 17th day of treatment.
Discussion: Drugs occasionally induce cutaneous side effects. Ecchymosis, rash, erythema, petechiae skin lesion and pruritus have been described in decitabine’s prospectus. Maculopapular eruptions can affect all age groups. This type of eruption is common with certain drugs as well as with several diseases and medical conditions including scarlet fever, measles, rubella, secondary syphilis, parvovirus B19 and heat rash. A number of drugs may cause the appearance of maculopapular eruptions.
Conclusion: Practitioners should be aware of this rare, but potentially serious, adverse event, especially as decitabine is commonly used for myelodysplastic syndromes and acute myeloid leukemia.