Cytarabine-induced auricular erythema in a patient with SF3B1 and RUNX1-mutated acute myeloid leukemia: A case report

Cytarabine (Ara-C) is a pyrimidine analog essential for treating hematological malignancies.While its systemic side effects are well-known, localized dermatological toxicities like “Ara-C ears” (auricular erythema) are rare. A 55-year-old female diagnosed with acute myeloid leukemia presented with an acute onsetof bilateral auricular pain, erythema, and tenderness occurring 48 h after completion of induction chemotherapy. Physical examination revealed intense erythema involving the entire pinna, including the lobule, without fever or systemic signs of infection. Based on the temporal association with Ara-C administration and exclusion ofinfectious and autoimmune causes, a diagnosis of Ara-C-induced auricular erythema was made. The patient was managed conservatively with antihistamines and supportive care, without interruption of chemotherapy. Complete resolution of symptoms occurred within 7 days, confirming the self-limiting nature of the condition.This case highlights a rare subtype of acral erythema. We hypothesize that the patient’s specificsplicing and transcriptional mutations may have influenced the inflammatory response. Recognition of this benign condition is vital to prevent misdiagnosis as relapsing polychondritis or cellulitis and to avoid unnecessary treatment interruptions.