Lam Cham Kee HX, Charra-Brunaud C, Cuny JF, Reigneau M, Vogin G, Peiffert D, et al.
Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique. Date of publication 2013 Feb 1;volume 17(1):54-7.
1. Cancer Radiother. 2013 Feb;17(1):54-7. doi: 10.1016/j.canrad.2012.10.012. Epub
2013 Jan 3.
[Case report of EPPER Syndrome (eosinophilic polymorphic pruritic eruption
associated with radiotherapy) in a patient treated against endometrial cancer].
[Article in French]
Lam Cham Kee HX(1), Charra-Brunaud C, Cuny JF, Reigneau M, Vogin G, Peiffert D.
Author information:
(1)Service de radiothérapie, centre Alexis-Vautrin, 6, avenue de
Bourgogne-Brabois, 54511 Vandœuvre-lès-Nancy, France.lck.dany@gmail.com
Acute and mainly late toxicity is a major concern for radiotherapists. Here, we
describe a case of a generalized acute eruption due to radiation, having a
superficial and deep perivascular lymphocytic infiltrate with numerous
eosinophils found in skin biopsy: the EPPER syndrome (eosinophilic polymorphic
pruritic eruption associated with radiotherapy). A patient who had endometrial
cancer was treated first by surgery, then radiotherapy developed the day
following the end of irradiation a generalized erythematous, pruriginous eruption
(pelvis, trunk, lower and upper limbs, neck, face, ears). Different tests with a
skin biopsy found a superficial and deep perivascular lymphohistiocytic
infiltrate with many eosinophils, confirming an EPPER syndrome. The description
of the syndrome was first published in 1999 by Rueda et al. (1999) [1]. Later on,
there have only been a few case reports on this subject. This syndrome can be
encountered in many cancers, but more frequently in cervix and breast carcinomas
and can occur up to nine and a half months after radiotherapy. The pathogenic
mechanism is unknown. Antihistamines, topical corticosteroids or oral
corticosteroids as well as ultraviolet B therapy have been used successfully to
treat EPPER syndrome. Some cases of spontaneous resolution are also described.
EPPER syndrome is probably largely underestimated due to its polymorphic
characteristics, its occurrence sometimes late after radiotherapy. Its knowledge
is essential to inform and treat patients correctly.
Copyright © 2012 Société française de radiothérapie oncologique (SFRO). Published
by Elsevier SAS. All rights reserved.
DOI: 10.1016/j.canrad.2012.10.012
PMID: 23291008 [Indexed for MEDLINE]
