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Hypersensitivity to Nitrogen Mustards in the Form of Erythema Multiforme: A Unique Adverse Reaction

Hypersensitivity to Nitrogen Mustards in the Form of Erythema Multiforme: A Unique Adverse Reaction Abstract Nitrogen mustard preparations have an established role in the treatment of Hodgkin's disease.1,2 They may be used in conjunction with radiation therapy or alone to ameliorate constitutional symptoms. Although the beneficial response to such therapy may be dramatic at first, after variable periods symptoms always return. Several serious toxic side effects may follow the administration of a nitrogen mustard. This and similar agents inhibit cell growth and damage rapidly proliferating tissue forming the basis of their therapeutic action. Unfortunately, normal tissue is as susceptible as neoplastic. Severe local reactions may develop from the extravasation of a nitrogen mustard into the subcutaneous tissues. Veins used for injection of concentrated solutions of mustard are subject to the development of thrombophlebitis. Systemic reaction include nausea and vomiting, depression of bone marrow function, destruction of lymphoid tissue and, rarely, skin eruption. Both herpes zoster and maculopapular reactions apparently unrelated to hypersensitivity have been observed.3 References 1. Wintrobe, M.M., et al: Chemotherapy of Leukemia, Hodgkin's Disease and Related Disorders . Ann Intern Med 41:447-464, 1954.Crossref 2. Karnofsky, D.A.: Chemotherapy of Hodgkin's Disease , Cancer 19:371-377, 1966.Crossref 3. Goodman, L.S., and Gilman, A.: The Pharmacological Basis of Therapeutics ed 2, New York: Macmillan Co, 1960, p 1423. 4. Lever, W.F.: Histopathology of the Skin , ed 4, Philadelphia: J. B. Lippincott Co, 1967, pp 126-127. 5. Costello, M.J., and DeFeo, C.P.: Recent Advances in the Diagnosis and Treatment of Bullous Dermatoses , NY J Med 63:3213, 1963. 6. Fromer, J.L., and Geokas, M.C.: Cutaneous Manifestations in Lymphomas , NY J Med 63: 3222-3227, 1963. 7. Davis, J., and Pack. G.T.: Erythema Multiforme Following Deep X-Ray Therapy , Arch Derm 66:41-48, 1952.Crossref 8. Eisen, H.N: " Hypersensitivity to Simple Chemicals ," in Laurence, H.S. (ed.): Cellular and Humoral Aspects of the Hypersensitive States , New York: Paul B. Hoeber, Inc, 1959. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Hypersensitivity to Nitrogen Mustards in the Form of Erythema Multiforme: A Unique Adverse Reaction

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Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1967.04410010113017
Publisher site
See Article on Publisher Site

Abstract

Abstract Nitrogen mustard preparations have an established role in the treatment of Hodgkin's disease.1,2 They may be used in conjunction with radiation therapy or alone to ameliorate constitutional symptoms. Although the beneficial response to such therapy may be dramatic at first, after variable periods symptoms always return. Several serious toxic side effects may follow the administration of a nitrogen mustard. This and similar agents inhibit cell growth and damage rapidly proliferating tissue forming the basis of their therapeutic action. Unfortunately, normal tissue is as susceptible as neoplastic. Severe local reactions may develop from the extravasation of a nitrogen mustard into the subcutaneous tissues. Veins used for injection of concentrated solutions of mustard are subject to the development of thrombophlebitis. Systemic reaction include nausea and vomiting, depression of bone marrow function, destruction of lymphoid tissue and, rarely, skin eruption. Both herpes zoster and maculopapular reactions apparently unrelated to hypersensitivity have been observed.3 References 1. Wintrobe, M.M., et al: Chemotherapy of Leukemia, Hodgkin's Disease and Related Disorders . Ann Intern Med 41:447-464, 1954.Crossref 2. Karnofsky, D.A.: Chemotherapy of Hodgkin's Disease , Cancer 19:371-377, 1966.Crossref 3. Goodman, L.S., and Gilman, A.: The Pharmacological Basis of Therapeutics ed 2, New York: Macmillan Co, 1960, p 1423. 4. Lever, W.F.: Histopathology of the Skin , ed 4, Philadelphia: J. B. Lippincott Co, 1967, pp 126-127. 5. Costello, M.J., and DeFeo, C.P.: Recent Advances in the Diagnosis and Treatment of Bullous Dermatoses , NY J Med 63:3213, 1963. 6. Fromer, J.L., and Geokas, M.C.: Cutaneous Manifestations in Lymphomas , NY J Med 63: 3222-3227, 1963. 7. Davis, J., and Pack. G.T.: Erythema Multiforme Following Deep X-Ray Therapy , Arch Derm 66:41-48, 1952.Crossref 8. Eisen, H.N: " Hypersensitivity to Simple Chemicals ," in Laurence, H.S. (ed.): Cellular and Humoral Aspects of the Hypersensitive States , New York: Paul B. Hoeber, Inc, 1959.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1967

References