1. Dermatitis due to intravesical mitomycin C: a delayed-type hypersensitivity reaction?
- Author
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Colver GB, Inglis JA, McVittie E, Spencer MJ, Tolley DA, and Hunter JA
- Subjects
- Administration, Intravesical, Aged, Aged, 80 and over, Alkylating Agents administration & dosage, Antigen-Presenting Cells immunology, Cystitis chemically induced, Female, Humans, Immunohistochemistry, Male, Microscopy, Electron, Middle Aged, Mitomycin, Mitomycins administration & dosage, Mitomycins immunology, Patch Tests, Urinary Bladder immunology, Urinary Bladder ultrastructure, Urinary Bladder Neoplasms drug therapy, Alkylating Agents adverse effects, Drug Eruptions etiology, Hypersensitivity, Delayed chemically induced, Mitomycins adverse effects
- Abstract
Mitomycin C is an alkylating agent, used by intravesical instillation to treat carcinoma of the bladder. Repeated instillations can induce cystitis and an eczematous eruption affecting the palms, soles and face. If these effects are due to delayed hypersensitivity with sensitization to mitomycin C occurring in the bladder wall, it should be possible to demonstrate antigen-presenting cells in the bladder wall and positive patch tests to the drug. Using an immuno-alkaline phosphatase method we have identified CDI+ cells in bladder epithelium and submucosa and have demonstrated Birbeck granules in a few cells. In further support of our hypothesis it was also possible to demonstrate delayed type hypersensitivity in 13 out of 26 patients who had received mitomycin instillations by applying the allergen as a patch test. These results indicate that the eczematous eruption in this group of patients is most likely a hypersensitivity reaction and that it may be mediated transvesically.
- Published
- 1990
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