Drug extravasation: a dreaded complication.

A 62-year-old man diagnosed with a stage I lung adenocarcinoma was treated by an upper right lobectomy. Eighteen months later an elevation of carcinoembryoinc antigen (CEA) was detected, and CT tomography revealed a stage IV disease. Chemotherapy including cisplatin (Platinol) and docetaxel (Taxotere) was administered. He presented 12 days after receiving an intravenous infusion because he noticed a burning sensation, erythema and blisters at the site of the last infusion and proximal to that area. On physical examination he had a 9×4.5 cm swollen area of erythema and multiple blisters. The diagnosis of delayed and distant docetaxel extravasation was made. The treatment consisted of normal saline washes, topical hydrocortisone and antibiotic-based ointment which produced relief of the symptoms. This reaction resolved over the next 6 weeks, leaving two areas of brownish pigmentation of the skin as the only sequelae.