Hematology/Oncology Department of Medicine, University of Wisconsin - Madison, Madison, WI, USA.
Dermatology Department, University of Wisconsin - Madison, Madison, WI, USA.
BMC Cancer. 2017 Dec 19;17(1):866. doi: 10.1186/s12885-017-3882-4.
Capecitabine is an oral prodrug of fluorouracil, which is a common agent used in the management of many solid tumor malignancies. Dermatologic reaction is common with various chemotherapy agents but is not commonly reported in the use of capecitabine. When adverse reactions of rashes occur, the offending agent is typically removed. We report here an unusual case of photosensitive lichenoid rash due to capecitabine which is managed conservatively without major alteration in treatment.
Seventy-three year old female with a diagnosis of stage IV breast cancer undergoing management with capecitabine presents with a rash during the summer months that is biopsy proven to be lichenoid photosensitive rash with likely offending agent being capecitabine. Her treatment was initially held despite having response to treatment, started on topical steroids after evaluation by dermatology. Given her response to treatment, drug was resumed with instructions to use sun precaution, sunscreen, and to complete course of topical steroids until rash resolution.
Drug-related rashes tend to lead to disruptions or alterations in treatments of malignancies, despite responses. Given the wide use of capecitabine in many different solid tumors, it is important to recognize this photosensitive related skin rash and to initiate appropriate precautions of sun safety and topical steroids to allow minimal disruptions in therapy and continue use of capecitabine.
卡培他滨是氟尿嘧啶的口服前体药物，氟尿嘧啶是治疗多种实体瘤恶性肿瘤的常用药物。各种化疗药物都会引起皮肤反应，但卡培他滨的皮肤反应并不常见。当出现皮疹等不良反应时，通常会停用引起不良反应的药物。我们在此报告一例罕见的卡培他滨引起的光敏性苔藓样皮疹，该病例采用保守治疗，在治疗方案中未做重大调整。
一名 73 岁女性，诊断为 IV 期乳腺癌，接受卡培他滨治疗，在夏季出现皮疹。皮疹活检证实为苔藓样光敏性皮疹，可能的致病药物是卡培他滨。尽管治疗有反应，她的治疗最初还是被暂停了，并在皮肤科评估后开始使用局部皮质类固醇。鉴于她的治疗反应，在给予使用防晒措施、防晒霜和完成局部皮质类固醇疗程直至皮疹消退的指示后，恢复了药物治疗。
尽管有治疗反应，药物相关性皮疹往往会导致恶性肿瘤治疗的中断或改变。鉴于卡培他滨在许多不同的实体瘤中的广泛应用，识别这种光敏相关的皮疹并采取适当的防晒和局部皮质类固醇预防措施非常重要，这可以将治疗中断降到最低限度，并继续使用卡培他滨。
