Chemotherapy-Related Reticulate Hyperpigmentation: A Case Series and Review of the Literature

Dermatology. 2015;231(4):312-8. doi: 10.1159/000439047. Epub 2015 Oct 1.

Abstract

Background: Inherited or acquired reticulate hyperpigmentation represents a heterogeneous group of infrequent dermatological conditions. The development of reticulate hyperpigmentation has so far been rarely reported to be associated with chemotherapeutic agents, including fluorouracil, bleomycin or a combination of cytarabine and idarubicin.

Case reports: We describe 5 cases of chemotherapy-related reticulate hyperpigmentation in patients treated with different chemotherapeutic regimens, in particular paclitaxel or cytarabine. The lesions were similar in all cases, with reticulate and/or linear hyperpigmented streaks, which were mainly located to the back and buttocks. Histology showed increased melanogenesis, which suggests a direct toxic effect of chemotherapy on melanocytes. Reflectance confocal microscopy was performed in 2 patients showing a similar pattern, with an increased amount of melanin in basal keratinocytes. These features have been compared with the available data through a literature review.

Conclusion: Reticulate hyperpigmentation is an underestimated but characteristic complication of chemotherapy. Neither specific management nor discontinuation of the chemotherapeutic regimen is required.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Carboplatin / adverse effects
  • Cyclophosphamide / adverse effects
  • Cytarabine / adverse effects
  • Dexamethasone / adverse effects
  • Drug Eruptions / etiology*
  • Drug Eruptions / pathology
  • Female
  • Humans
  • Hyperpigmentation / chemically induced*
  • Hyperpigmentation / pathology
  • Idarubicin / adverse effects
  • Lomustine / adverse effects
  • Male
  • Middle Aged
  • Paclitaxel / adverse effects
  • Vincristine / adverse effects

Substances

  • Antineoplastic Agents
  • Cytarabine
  • Vincristine
  • Lomustine
  • Dexamethasone
  • Cyclophosphamide
  • Carboplatin
  • Paclitaxel
  • Idarubicin