Cyclophosphamide/doxorubicin

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Palmar-plantar erythema: case report A 43-year-old woman developed palmar-plantar erythema while receiving doxorubicin and cyclophosphamide for breast cancer. The woman received two cycles of adjuvant 3-weekly chemotherapy with IV doxorubicin 60 mg/m2 and IV cyclophosphamide 600 mg/m2, in total doses of 110mg and 1000mg respectively. She also received metoclopramide, prochlorperazine, dexamethasone and ondansetron. However, she developed emesis. Consequently, she received aprepitant with her third cycle. Ten days after her third cycle, she developed a sudden onset of erythema and painful burning feelings in her feet and blisters on her plantar surfaces that prevented walking. She also had erythematous swollen hands with dysaesthesia. Blood tests revealed neutropenia, with a WBC count of 1.2 x 109/L and a neutrophil count of 0.4 x 109/L. Within 24 hours, desquamation started on her non-blistered areas. The woman received supportive hospital care for 6 days, with protective footwear, daily sterile dressings and oxycodone. Over 1 week, her skin changes resolved spontaneously without residual scarring. Aprepitant was withdrawn from her fourth cycle of chemotherapy, because it was considered a possible cause of her skin reaction. Her doxorubicin and cyclophosphamide doses were reduced to 90mg and 900mg, respectively, to avoid emesis. Two hours after chemotherapy was completed, her erythema recurred. She received supportive hospital care for 16 days, and oxycodone for more severe pain. Over 4 weeks, her skin changes resolved spontaneously. She completed her chemotherapy with no further relapse. Damasiewicz MJ, et al. Severe palmar-plantar erythema in a patient with breast cancer receiving doxorubicin-cyclophosphamide chemotherapy. Internal Medicine 801090206 Journal 37: 505-506, No. 7, Jul 2007 - Australia

0114-9954/10/1162-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Reactions 28 Jul 2007 No. 1162

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