Antineoplastics
1
Reactions 1384 - 14 Jan 2012 Antineoplastics Cutaneous reactions: 4 case reports Four patients developed cutaneous adverse reactions while receiving taxane-based chemotherapy [routes and dosages not stated; not all outcomes stated]. A 54-year-old woman with metastatic breast cancer began receiving paclitaxel and carboplatin. Two months later, she presented with erythema, hyperchromia and dysaesthesia on her face and hands. She applied moisturiser and sunscreen, and avoided exposure to the sun. Two months later, paclitaxel was replaced with docetaxel, and her symptoms improved. After two cycles of docetaxel, she developed phlebitis at the infusion site, with linear hyperpigmentation. Her facial lesions were treated with fluocinolone acetonide/hydroquinone/tretinoin, and the lesions on her hands were treated with hydroquinone/ glycolic acid, heparinoid and photoprotection. Her symptoms improved after 30 days. After starting a new cycle of docetaxel, she developed facial erythema, desquamation and hyperpigmentation. Eleven months later, after stopping docetaxel, she had melasma and mottled hyperpigmentation on her face. An 84-year-old man began receiving paclitaxel and carboplatin for lung cancer. Three months later, he presented with paronychia in his big toes. The nail plates were thick and yellowish, with onycholysis and inflammation of the underlying nail bed and periungual tissue. He underwent avulsion of the nail bed. Forty days later, after completing chemotherapy, the nails and periungual tissue showed no signs of inflammation, and nail growth was seen. A 49-year-old woman with breast cancer began receiving chemotherapy with docetaxel, doxorubicin and cyclophosphamide. After the fourth cycle, she presented with erythema and dysaesthesia on her hands. After the fifth cycle, she had erythema and dysaesthesia on her hands and heels. She was treated with prednisone, mometasone and moisturiser, with partial improvement. Her symptoms recurred with greater intensity after each new chemotherapy cycle. A 44-year-old woman began receiving paclitaxel for metastatic breast cancer. Four months later, she presented with infiltrated maculi and hyperpigmentation on her hands, periungual pain in her hands and feet, a subungual abscess and local onycholysis. She was treated with prednisone, hydroquinone/glycolic acid, opioids and moisturiser, with mild improvement. A few days later, she developed a whitlow, with worsening erythema and dysaesthesia on her hands and face. New lesions began to appear on her fingers and toenails. Chemotherapy was discontinued, and her symptoms gradually remitted. Donati A, et al. Cutaneous adverse reactions to chemotherapy with taxanes. The dermatologist’s point of view. Anais Brasileiros de Dermatologia 86: 755-758, No. 4, Aug 2011. Available from: URL: http://dx.doi.org/10.1590/ s0365-05962011000400020 [Portuguese; summarised from a translation] - Brazil 803065126 1 Reactions 14 Jan 2012 No. 1384 0114-9954/10/1384-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1384 - 14 Jan 2012
Antineoplastics
Cutaneous reactions: 4 case reportsFour patients developed cutaneous adverse reactions
while receiving taxane-based chemotherapy [routes anddosages not stated; not all outcomes stated].
A 54-year-old woman with metastatic breast cancerbegan receiving paclitaxel and carboplatin. Two monthslater, she presented with erythema, hyperchromia anddysaesthesia on her face and hands. She appliedmoisturiser and sunscreen, and avoided exposure to thesun. Two months later, paclitaxel was replaced withdocetaxel, and her symptoms improved. After two cycles ofdocetaxel, she developed phlebitis at the infusion site, withlinear hyperpigmentation. Her facial lesions were treatedwith fluocinolone acetonide/hydroquinone/tretinoin, andthe lesions on her hands were treated with hydroquinone/glycolic acid, heparinoid and photoprotection. Hersymptoms improved after 30 days. After starting a newcycle of docetaxel, she developed facial erythema,desquamation and hyperpigmentation. Eleven monthslater, after stopping docetaxel, she had melasma andmottled hyperpigmentation on her face.
An 84-year-old man began receiving paclitaxel andcarboplatin for lung cancer. Three months later, hepresented with paronychia in his big toes. The nail plateswere thick and yellowish, with onycholysis andinflammation of the underlying nail bed and periungualtissue. He underwent avulsion of the nail bed. Forty dayslater, after completing chemotherapy, the nails andperiungual tissue showed no signs of inflammation, andnail growth was seen.
A 49-year-old woman with breast cancer began receivingchemotherapy with docetaxel, doxorubicin andcyclophosphamide. After the fourth cycle, she presentedwith erythema and dysaesthesia on her hands. After thefifth cycle, she had erythema and dysaesthesia on herhands and heels. She was treated with prednisone,mometasone and moisturiser, with partial improvement.Her symptoms recurred with greater intensity after eachnew chemotherapy cycle.
A 44-year-old woman began receiving paclitaxel formetastatic breast cancer. Four months later, she presentedwith infiltrated maculi and hyperpigmentation on herhands, periungual pain in her hands and feet, a subungualabscess and local onycholysis. She was treated withprednisone, hydroquinone/glycolic acid, opioids andmoisturiser, with mild improvement. A few days later, shedeveloped a whitlow, with worsening erythema anddysaesthesia on her hands and face. New lesions began toappear on her fingers and toenails. Chemotherapy wasdiscontinued, and her symptoms gradually remitted.Donati A, et al. Cutaneous adverse reactions to chemotherapy with taxanes. Thedermatologist’s point of view. Anais Brasileiros de Dermatologia 86: 755-758, No.4, Aug 2011. Available from: URL: http://dx.doi.org/10.1590/s0365-05962011000400020 [Portuguese; summarised from a translation] -Brazil 803065126
1
Reactions 14 Jan 2012 No. 13840114-9954/10/1384-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
