{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T16:10:17Z","timestamp":1759939817918,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,1,4]]},"abstract":"<jats:p>Acute promyelocytic leukaemia is among the most curable haematological malignancies after the introduction of differentiating agents (arsenic trioxide (ATO) and all-trans-retinoic-acid (ATRA)). Despite excellent cure rates, approaching 85\u201395% in various series, APL is associated with significant early mortality and morbidity. ATRA-related side effects partly contribute to this morbidity, which commonly presents as differentiation syndrome, pseudo tumour cerebri, dermatitis, gastrointestinal disorders, liver dysfunction (raised transaminases) and dryness of skin\/eyes. Rarely, ATRA can lead to hypercalcaemia, genital vasculitis, erythaema nodosum and Sweet's syndrome. We present two cases of ATRA-associated genital vasculitis while being managed with a combination of ATO with ATRA therapy. Both patients developed these lesions despite being on prophylactic steroids (0.5\u2005mg\/kg). We also discuss the pathophysiology, clinical manifestations, differential diagnosis and treatment of genital vasculitis as a rare adverse event of ATRA.<\/jats:p>","DOI":"10.1136\/bcr-2015-212205","type":"journal-article","created":{"date-parts":[[2016,2,14]],"date-time":"2016-02-14T21:09:17Z","timestamp":1455484157000},"page":"bcr2015212205","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Genital vasculitis secondary to all-trans-retinoic-acid"],"prefix":"10.1136","volume":"2016","author":[{"given":"Uday","family":"Yanamandra","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India"},{"name":"Department of Internal Medicine (Clinical Hematology Division), Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alka","family":"Khadwal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (Clinical Hematology Division), Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uma","family":"Nahar Saikia","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pankaj","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (Clinical Hematology Division), Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,1,20]]},"reference":[{"key":"2025082701513436000_2016.jan20_1.bcr2015212205.1","doi-asserted-by":"crossref","first-page":"3322","DOI":"10.1182\/blood.V126.23.3322.3322","article-title":"High risk APML treated successfully with four cycles of ATO and ATRA combination in resource constrained settings","volume":"126","author":"Varma","year":"2015","journal-title":"Blood"},{"key":"2025082701513436000_2016.jan20_1.bcr2015212205.2","doi-asserted-by":"crossref","first-page":"613","DOI":"10.3109\/10428199809057622","article-title":"Sweet's syndrome during treatment all-trans retinoic in a patient with acute promyelocytic leukemia","volume":"31","author":"Arun","year":"1998","journal-title":"Leuk Lymphoma"},{"key":"2025082701513436000_2016.jan20_1.bcr2015212205.3","doi-asserted-by":"crossref","unstructured":"Yanamandra U , Sahu KK , Khadwal A , et al . All-trans-retinoic-acid unmasking hypercalcemia of hyperparathyroidism. 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