Hiperpigmentación secundaria a capecitabina

Chemotherapy and skin reactions

Background

New chemotherapic agents and new protocols in oncology have led to an increasing survival rate in patients affected by tumors. However, this increased use has been accompanied by a growth in the incidence of cutaneous side effects and a worsening of patients’ quality of life. Appropriate management of skin toxicity associated with chemotherapic agents is therefore necessary for suitable drug administration and to improve quality of life and clinical outcomes.

Methods

We have clinically examined 100 patients affected by cancer, determining type, frequency, treatment, and evolution of side effects related to chemotherapy.

Results

The prevalent cutaneous side effects in patients undergoing chemotherapy are skin rash, xerosis, pruritus, paronychia, hair abnormality, and mucositis. The clinical cases are reported in detail.

Conclusion

Oncological therapies have become more selective and have low systemic toxicity because of their high specificity, but cutaneous side effects are common and may worsen the quality of life of these patients.

Focal acral hyperpigmentation in a patient undergoing chemotherapy with capecitabine

Capecitabine is a prodrug of fluorouracil. Systemic immunosuppression has been reported as a cause of eruptive pigmented lesions, although the mechanisms causing this eruption are not known. A 58-year-old woman undergoing chemotherapy with capecitabine presented with multiple pigmented macules on the skin and tongue, and generalized hyperpigmentation, which finally faded after the drug was discontinued. Capecitabine may induce the growth of normal and dysplastic melanocytic nevi, and lentiginous melanocytic hyperplasia. Careful follow-up is mandatory, since the risk of developing melanoma in these cases remains uncertain.