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

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Reactions 14 Jan 2012 No. 13840114-9954/10/1384-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved