This case report describes the successful use of total skin electron beam (TSEB) radiation on a 60-year old man with telangiectasia macularis eruptive perstans (TMEP). The patient presented with symptoms of flushing and pruritic reddish-brown macular eruption on his trunk and proximal extremities. A biopsy confirmed the diagnosis of TMEP, and subsequent workup for systemic mast cell disease was negative. Various modalities were tried for the patient's pruritus, including topical steroids, multiple antihistamines, colchicine, prednisone, and UVB and PUVA phototherapy. UVB phototherapy improved the patient's lesions and symptoms, but these recurred 6 weeks after discontinuation. PUVA phototherapy yielded similar results.
A trial TSEB was begun on the patient. The patient continued antihistamines in order to minimize effects from the potential release of histamine during mast cell irradiation. Initially, a test dose of 3000 cGys was administered to the patient's shoulder. The patient reported significant improvement in symptoms as well as clearing of lesions. He then underwent TSEB therapy over six weeks, receiving whole-body radiation 4 days a week and radiation to his feet 1 day a week, for a total dose of 4000 cGys given over 40 fractionated treatments. The patient reported no adverse side effects from the treatment and over the course of his treatment, all cutaneous signs and symptoms and TMEP resolved. He remained clear and symptom-free one year following TSEB.
Monahan TP et al. Treatment of Telangiectasia Macularis Eruptiva Perstans with Total Skin Electron Beam Radiation. Cutis 2003; 71:357-359.
COPYRIGHT 2003 Journal of Drugs in Dermatology
COPYRIGHT 2003 Gale Group
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