Dermatological Toxicity from Chemotherapy Containing 5-Fluorouracil

Abstract

5-Fluorouracil (5-FU) is an antimetabolite frequently used in the treatment of cancer. The most common adverse reactions are acute gastrointestinal effects and bone marrow suppression while neurological, ocular and dermatological toxicities are unusual. Several cutaneous manifestations can be found. They are hyperpigmentation, maculo-papular eruption and palmar-plantar erythrodysesthesia (PPES) promptly reversed with discontinuation of 5-FU. The etiopathogenesis of such manifestations is still unknown particularly as regards PPES, but it has been postulated that the local drug accumulation secondary to different scheduling (continuous infusion instead of bolus infusion), the total amount of drug, alcoholism, local trauma, increased blood flow could be responsible for them. In this study we have reported 10 cases of dermatological toxicity (1 of these had PPES) observed from January '91 to December '93 in 81 patients treated with bolus injection of 5-FU containing combination chemotherapy.

Focal Acral Hyperpigmentation in a Patient Undergoing Chemotherapy with Capecitabine

“…[13] Different adverse effects have been recognized for capecitabine and fluorouracil. [14] The most common adverse reactions to fluorouracil are acute gastrointestinal effects and bone marrow suppression. Several cutaneous manifestations can also be found, including hyperpigmentation (generalized and focal, either by melanocytic stimulation or by supravenous post-inflammatory hyperpigmentation), maculo-papular eruption, palmar-plantar erythrodysesthesia, and nail abnormalities.…”

Toxicoderma Secondary to 5-Fluorouracil: Differential Diagnosis of Paraneoplastic Pemphigus

“…The most common side effects are myelosuppression, diarrhoea, mucositis and, somewhat less frequently, dermatitis. A large variety of cutaneous affections associated with this drug have been described, such as alterations of pigmentation, palmar-plantar erythrodysesthesia, lupus erythematosus-like lesions, seborrheic dermatitis, photosensitivity, nail abnormalities or septal granulomatous panniculitis [2][3][4][5]. Among these, the most typical cutaneous condition associated with 5-FU is palmar-plantar erythrodysesthesia, which appears rarely with bolus administrations, but is most often seen with continuous infusion (upto 34%) [6].…”

Hand-Fuß-Syndrom bei einem Patienten unter Capecitabin-Therapie

“…Dieses Enzym ist im Tumorgewebe in wesentlich höherer Konzentration vorhanden als in gesundem Gewebe. Deshalb wird der aktive zytotoxische Wirkstoff 5-Fluorouracil vorwiegend im Tumorgewebe gebildet [7,21]. Im Gewebe kommt es zur Akkumulation der entsprechenden 5-Fluorouracil-Metabolite (z.…”