Maculopapular eruption with enlarged macrophages in eight patients receiving G-CSF or GM-CSF

J Eur Acad Dermatol Venereol. 2004 May;18(3):310-3. doi: 10.1111/j.1468-3083.2004.00872.x.


In the last years, granulocyte and granulocyte-macrophage colony-stimulating factors (G-CSF and GM-CSF) are being increasingly used and several cutaneous eruptions have been reported in relation to these treatments. In 1991 Horn et al. described three patients with maculopapular eruption that paralleled the time of infusion of GM-CSF. Two of the cases showed an increase in the number and size of macrophages in the biopsy specimen. Since then, several cases have been reported showing this histopathological alteration that has been considered characteristic of reaction to G-CSF or GM-CSF. Although maculopapular eruption with enlarged macrophages can appear after chemotherapy treatment, we have found that the presentation of this eruption after the beginning of cytokine treatment is suggestive of the involvement of G-CSF and GM-CSF in the eruption. We described eight cases of patients treated with G-CSF or GM-CSF that developed maculopapular eruptions with enlarged macrophages.

MeSH terms

  • Adult
  • Biopsy, Needle
  • Drug Eruptions / drug therapy
  • Drug Eruptions / etiology*
  • Drug Eruptions / pathology*
  • Exanthema / chemically induced*
  • Exanthema / drug therapy
  • Exanthema / pathology*
  • Female
  • Granulocyte Colony-Stimulating Factor / adverse effects*
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Granulocyte-Macrophage Colony-Stimulating Factor / adverse effects*
  • Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use
  • Hematologic Neoplasms / drug therapy
  • Hematologic Neoplasms / pathology
  • Humans
  • Immunohistochemistry
  • Macrophages / pathology
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Steroids / therapeutic use
  • Treatment Outcome


  • Steroids
  • Granulocyte Colony-Stimulating Factor
  • Granulocyte-Macrophage Colony-Stimulating Factor