Curtis Susanna, Hong Simon, Gucalp Rasim, Calvo Manuela
Department of Medicine, Montefiore Medical Center, Bronx, NY.
Am J Ther. 2016 Jan-Feb;23(1):e321-3. doi: 10.1097/MJT.0000000000000024.
Gemcitabine is a chemotherapeutic agent used for treatment of a variety of malignancies. It has been associated with multiple cutaneous reactions including rash, alopecia, and pruritus. Less commonly, gemcitabine has been associated with "pseudocellulitis," a noninfectious skin inflammatory reaction, which resembles cellulitis. The majority of cases reported in the literature are radiation recall reactions in which inflammation occurs in areas of previous radiation post drug treatment; however, there are also reports of pseudocellulitis occurring in areas of preexisting lymphedema. The pathophysiology of both of these reactions are still unknown, though it is theorized that areas of lymphedema may both increase concentration of gemcitabine and reduce its rate of metabolism leading to increased drug exposure time. In this study, we report a case of pseudocellulitis in a patient with chronic lower extremity lymphedema and a review of the current literature. By recognizing this side effect of gemcitabine, one can avoid unnecessary hospitalization and exposure to antibiotics.
吉西他滨是一种用于治疗多种恶性肿瘤的化疗药物。它与多种皮肤反应有关，包括皮疹、脱发和瘙痒。较少见的是，吉西他滨与“假性蜂窝织炎”有关，这是一种非感染性皮肤炎症反应，类似于蜂窝织炎。文献报道的大多数病例是放射性回忆反应，即在药物治疗后先前接受过放疗的部位发生炎症；然而，也有报道称假性蜂窝织炎发生在已有淋巴水肿的部位。这两种反应的病理生理学仍不清楚，不过据推测，淋巴水肿部位可能既会增加吉西他滨的浓度，又会降低其代谢速率，从而导致药物暴露时间延长。在本研究中，我们报告了一例慢性下肢淋巴水肿患者发生假性蜂窝织炎的病例，并对当前文献进行了综述。通过认识到吉西他滨的这种副作用，人们可以避免不必要的住院治疗和接触抗生素。
