Capecitabine
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Capecitabine Discoid lupus erythematosus: case report
A 79-year-old woman developed discoid lupus erythematosus (DLE) during treatment with capecitabine for metastatic rectosigmoid cancer. The woman had undergone surgical resection of the cancer, and received six cycles of leucovorin [folinic acid] and fluorouracil [5-fluorouracil]. Thereafter, she started receiving oral capecitabine [dosage not stated]. Five months after capecitabine initiation, she developed progressive skin lesions presenting as indurated dusky erythematous plaques with scales on the cheeks featuring malar rash and discoid rashes on the philtrum and forehead. She experienced no irritation or itching. She had no history of lupus erythematosus. A histopathology of the punch biopsy specimen collected from her right cheek lesion demonstrated epidermal flattening and thinning with basal vacuolar degeneration and follicular plugging. Lymphohistiocytic infiltrates were observed around the hair follicle and densely along the dermal-epidermal junction. Patchy inflammatory infiltrate spread into the deep dermis. Solar elastosis and deposition of the interstitial mucin was also detected. Direct immunofluorescence staining demonstrated IgM deposition along the dermal-epidermal junction. Laboratory investigations were positive for anti-SSA antibodies and negative for antinuclear antibodies. Her biochemical and haematologic blood tests showed normal results. These findings were consistent with drug-induced DLE. The woman’s capecitabine therapy was therefore discontinued. Within one month, her dermatologic symptoms improved. Thereafter, she was started on FOLFIRI regimen comprising folinic acid, fluorouracil and irinotecan without appearance of new skin lesion. It was concluded that DLE was induced by capecitabine as she did not develop skin lesions before and after the use of chemotherapy regimens containing fluorouracil. Heo JH, et al. A case of capecitabine-induced discoid lupus erythematosus. Annals of Dermatology 32: 348-350, No. 4, Aug 2020. Available from: URL: http:// doi.org/10.5021/ad.2020.32.4.348
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Reactions 26 Sep 2020 No. 1823
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