Moreno de Vega M J, Dauden E, Abajo P, Bartolome B, Fraga J, Garcia-Diez A
Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain.
J Eur Acad Dermatol Venereol. 2002 Sep;16(5):488-90. doi: 10.1046/j.1468-3083.2002.00564.x.
Skin necrosis from intravenous infiltration of soft tissue is a rare but potentially devastating complication of intravenous therapy. Vinca alkaloids are among the intravenous drugs with the highest destructive power. We report two cases of skin necrosis from accidental extravasation of vinorelbine, a semisynthetic analogue of vinblastine, rarely described as being responsible for this event. Histopathologic study showed separation of the dermis from necrotic epidermis, associated with cytologic atypia, in both patients, and focal necrosis of eccrine glands in one of them. We consider that intravenous infusions of vinorelbine should be performed using the preventive measures and care applied for other chemotherapeutic agents with high potential for induction of skin necrosis due to extravasation.
软组织静脉内浸润导致的皮肤坏死是静脉治疗中一种罕见但可能具有毁灭性的并发症。长春花生物碱是具有最高破坏力的静脉用药之一。我们报告了两例因长春瑞滨意外外渗导致皮肤坏死的病例，长春瑞滨是长春碱的半合成类似物，很少被描述为导致这一事件的原因。组织病理学研究显示，两名患者的真皮与坏死表皮分离，并伴有细胞异型性，其中一名患者的汗腺有局灶性坏死。我们认为，输注长春瑞滨时应采取预防措施并给予护理，这些措施适用于其他因外渗而有高诱导皮肤坏死可能性的化疗药物。
