Erythroderma Flare-Up Caused by Chemoradiation
DOI:
https://doi.org/10.66765/acobs.2026.008Keywords:
Erythroderma, Radiotherapy, Rectal Neoplasms, Combined Modality Therapy, Adrenal Cortex Hormones, Emollients, Drug-Related Side Effects and Adverse Reactions, Dermatology, Radiation Injuries, Multidisciplinary Care Team, Case ReportAbstract
Background: Exfoliative erythroderma is a rare dermatological condition characterized by widespread erythema and scaling. It may occur idiopathically or be triggered by pre-existing skin diseases, systemic conditions, or medications.
Case Representation: A 55-year-old female undergoing chemoradiation for rectal cancer developed a systemic flare-up of erythroderma during radiation therapy.
Management and Outcome: The patient was treated with topical and systemic corticosteroids along with emollients and moisturizers. Her symptoms improved significantly and resolved within one month of diagnosis. Dexamethasone was initiated at a dose of 4 mg three times daily and subsequently tapered according to clinical response. Topical clobetasone was administered concurrently for local symptom management.
Conclusion: Radiation-associated erythroderma is an uncommon adverse event. Early recognition and a multidisciplinary approach involving dermatology, radiation oncology, and medical oncology are essential for effective management and favorable outcomes.
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References
1. Sehgal VN, Srivastava G, Sardana K. Erythroderma/exfoliative dermatitis: a synopsis. Int J Dermatol. 2004;43(1):39–47.
2. Hulmani M, Nandakishore B, Bhat MR, et al. Clinico-etiological study of 30 erythroderma cases from tertiary center in South India. Indian Dermatol Online J. 2014;5(1):25–29.
3. Sigurdsson V, Steegmans PH, van Vloten WA. The incidence of erythroderma: a survey among all dermatologists in The Netherlands. J Am Acad Dermatol. 2001;45(5):675–678.
4. Rothe MJ, Bialy TL, Grant-Kels JM. Erythroderma. Dermatol Clin. 2000;18(3):405–415.
5. Lorimer PD, Motz BM, Kirks RC, et al. Pathologic complete response rates after neoadjuvant treatment in rectal cancer: an analysis of the National Cancer Database. Ann Surg Oncol. 2017;24(8):2095–2103.
6. Deloch L, Derer A, Hartmann J, et al. Modern radiotherapy concepts and the impact of radiation on immune activation. Front Oncol. 2016;6:141.
7. Gaipl US, Multhoff G, Scheithauer H, et al. Kill and spread the word: stimulation of antitumor immune responses in the context of radiotherapy. Immunotherapy. 2014;6(5):597–610.
8. Barker HE, Paget JT, Khan AA, et al. The tumour microenvironment after radiotherapy: mechanisms of resistance and recurrence. Nat Rev Cancer. 2015;15(7):409–425.
9. Baker DG, Krochak RJ. The response of the microvascular system to radiation: a review. Cancer Invest. 1989;7(3):287–294.
10. Monjazeb AM, Schalper KA, Villarroel-Espindola F, et al. Effects of radiation on the tumor microenvironment. Semin Radiat Oncol. 2020;30(2):145–157.
11. Gómez V, Mustapha R, Ng K, et al. Radiation therapy and the innate immune response: clinical implications for immunotherapy approaches. Br J Clin Pharmacol. 2020;86(9):1726–1735.
12. Crittenden M, Kohrt H, Levy R, et al. Current clinical trials testing combinations of immunotherapy and radiation. Semin Radiat Oncol. 2015;25(1):54–64.
13. Lowes MA, Suarez-Fariñas M, Krueger JG. Immunology of psoriasis. Annu Rev Immunol. 2014;32(1):227–255.
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