Atypical skin metastases from early tubular breast carcinoma

upper epidermal layers than in the deeper layers, inflicting nonimmunologic direct toxicity to keratinocytes in outer layers manifesting as EMor TEN-like clinically while local friction, occlusion and heat evidently contribute towards its severity. The concept is also substantiated by negative patch testing, macrophage migration or indirect rat mast cell degranulation tests, EMor TEN-like histology and subsidence of rash after withdrawal of the offending drug in most cases. 1,2,4,5 We feel that until the exact nature of such cutaneous adverse drug reaction gets established, it should be accepted and documented as “intertriginous drug eruption” and evaluated as such.

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