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Figure 1. Chemotherapy-Induced Acral Erythema.
Acral cyanosis can be seen in a 61-year-old woman with non-Hodgkin's lymphoma. The lesions developed while the patient had severe neutropenia during a course of therapy consisting of methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin. The disorder is characterized by intense, painful erythema of the palms and soles, often culminating in the formation of vesicles or bullae. Chemotherapeutic agents are one of the known causes.
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