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Cutaneous eruption of lymphocyte recovery
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Cutaneous eruption of lymphocyte recovery

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Contributors: Connie Zhong, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Cutaneous eruption of lymphocyte recovery (ELR) is an eruption that occurs in the setting of an increasing lymphocyte count after bone marrow ablating chemotherapy. The rash typically appears 1-3 weeks after a chemotherapeutic regimen, when the lymphocyte count is beginning to recover. ELR is characterized by confluent erythematous macules and papules that are pruritic. Sometimes, erythroderma ensues. Within a few days of the appearance of the rash, the patient typically has 2-3 days of fever with negative blood and urine cultures. Several days after the fever, the eruption resolves spontaneously with possible desquamation and residual hyperpigmentation.

The pathophysiology of ELR is unclear, although it is postulated that it may be due to defective suppression of lymphocytes during rapid immunologic reconstitution or the preferential migration of T-lymphocytes to the skin to re-establish skin-associated lymphoid tissue.

Codes

ICD10CM:
R21 – Rash and other nonspecific skin eruption

SNOMEDCT:
271807003  –  Eruption of skin

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 07/11/2017
Last Updated: 07/28/2017
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Cutaneous eruption of lymphocyte recovery
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Cutaneous eruption of lymphocyte recovery : Fever, Erythema, Pruritus, 6 to 21 days after chemotherapy nadir
Copyright © 2019 VisualDx®. All rights reserved.