This 72-year-old man developed a generalized eczematous eruption after the fifth intravesical instillation of mitomycin C for treatment of transitional cell carcinoma of the bladder following endoscopic resection of the tumor.Repeated intravesical instillations of this alkylating agent can induce cystitis and an eczematous eruption affecting the palms, soles and face. If these effects are due to a delayed hypersensitivity with sensitization to mitomycin C occurring in the bladder, it should be possible to demonstrate antigen-presenting cells in the bladder wall. Positive patch testing in sensitized patients has been reported suggesting that the eczematous eruption most likely represents a type IV delayed hypersensitivity reaction that is mediated transvesically. Discontinuation of the drug results in clearing of the skin eruption. Dermatologists and anyone involved in the treatment of these patients should be aware of this complication of therapy. (Kunkeler L, Nieboer C, Bruynzeel DP. Type III and type IV hypersensitivity reactions due to mitomycin C.Contact Dermatitis. 2000 Feb;42(2):74-6)
