Recall dermatitis

Burstein HJ. Side effects of chemotherapy. Case 1. Radiation recall dermatitis from gemcitabine. J Clin Oncol 2000 18(3) 693-694. 

Tamoxifen has several adverse effects on the skin, including edema, flushing, rashes, hyperhidrosis, urticaria, alopecia, and hypertrichosis. Radiation recall dermatitis, a severe painful inflammatory skin reaction in sites that have previously been exposed to ionized radiation, can occur in patients taking tamoxifen (59). In one case the tamoxifen was withdrawn and the skin healed spontaneously in 7 weeks (60). Toremifene, a tamoxifen analogue, was well tolerated during 18 months of continuous treatment no signs of radiation recall developed. 

Of 99 patients who received low-dose docetaxel (60 mg/m every 3 or 4 weeks), 25 had skin toxicity, mainly erythema and nail changes (7). Of a subset of 25 patients who received irradiation before docetaxel, four had recall dermatitis during their first infusion of docetaxel. AH had previously received doxorubicin, which may in part have explained some of the toxicity. 

Radiation recall dermatitis developed in a 29-year-old woman after high-dose intravenous interferon alfa-2b was given 5 days after the completion of radiotherapy for malignant melanoma (300). 

Thomas R, Stea B. Radiation recall dermatitis from high-dose interferon alfa-2b. J Clin Oncol 2002 20(l) 355-7. 

Raghavan VT, Bloomer WD, Merkel DE. Taxol and radiation recall dermatitis. Lancet 1993 341(8856) 1354. 

Radiation recall dermatitis developed 7 months after radiotherapy for breast cancer in a 56-year-old woman who took levofloxacin for an upper respiratory tract infection [37 ]. 

Wernicke AG, Swistel AJ, Parashar B, Myskowski PL. Levofloxacin-induced radiation recall dermatitis a case report... 

El Sayed F, Bazex J (1994) Airborne contact dermatitis from chromate in cement with recall dermatitis on patch testing. Contact Dermatitis 30 58... 

Skin Recall dermatitis has been reported in a 61-year-old man who underwent patch testing with neomycin localized allergic contact dermatitis developed at previous neomycin-treated sites ph ]. 

Pleural effusions or ascites In patients with significant third space accumulations, evacuate the fluid before treatment and monitor plasma methotrexate levels. Psoriasis lesions Lesions of psoriasis may be aggravated by concomitant exposure to ultraviolet radiation. Radiation dermatitis and sunburn may be recalled by the use of methotrexate. 

Radiation recall consists of inflammatory reactions triggered by cytotoxic drugs in previously irradiated areas most are skin reactions. Gemcitabine has been implicated in several cases. The authors of a literature review discovered 12 cases of radiation recall caused by gemcitabine and reported a case of myositis in the rectus abdominis muscle of a patient with pancreatic adenocarcinoma as an effect of radiation recall (23). Most of the cases had inflammation of internal organs or tissues and 30% had dermatitis or mucositis. This is different from the effect of other agents that commonly cause radiation recall (anthracyclines and taxanes), with which 63% are skin reactions. Compared with anthracyclines and taxanes, the interval from the completion of radiation therapy to the start of chemotherapy is less with gemcitabine (median time 56 days, compared with 218 days for the taxanes and 646 days for doxorubicin). 

Originally described as a type of systemic contact dermatitis characterized by a pruritic exanthem involving the buttocks and major flexures - groins and axillae, some investigators believe that this entity is a form of recall phenomenon. In children, it is important in the differential diagnosis of viral exanthems. 

The point prevalence includes only subjects with actual OCD. Since OCD is often a chronically relapsing disease, the point prevalence is therefore less informative than the period prevalence. However, the accuracy of recall will decrease with time, because persons who did not have complaints recently are more likely to forget to report their earlier contact dermatitis. 

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