Capecitabine-induced Systemic Lupus Erythematosus and Palmoplantar Erythrodysesthesia

June 2012 | Volume 11 | Issue 6 | Case Reports | 769 | Copyright © June 2012


Alison Wiesenthal MD,a Ryan Matherne MD,b and Bernard Gibson MDb

aUniversity of Texas Health Science Center San Antonio, San Antonio, TX bDepartment of Dermatology, University of Texas Medical Branch, Galveston, TX

A study of other oral prodrugs of 5-FU such as Tegafur have suggested Anti-SSA/Ro antibody to be a risk factor for drug eruptions.7 The authors speculate that 5-FU may translocate SSA/Ro antigens to the surface of keratinocytes, leading to a lupus-like eruption.7 While the mechanism remains unclear, it is evident that capecitabine is responsible for a number of dermatologic side effects.
As use of this drug continues to grow in the fight against metastatic breast, colorectal, and genitourinary cancers, it is important to recognize the breadth of cutaneous clinical presentations of capecitabine side effects. In conclusion, we present a unique case of capecitabine-induced SLE concurrent with PPE successfully treated with cessation of the offending agent and topical triamcinolone applied to affected areas.

DISCLOSURES

The authors have no relevant conflicts of interest to disclose.

REFERENCES

  1. Cassidy J, Twelves C, Van Cutsem E, et al. First-line oral capecitabine therapy in metastatic colorectal cancer: a favorable safety profile compared with intravenous 5-fluorouracil/leucovorin. Ann Oncol. 2002;13:566-575.
  2. Walko CM, Lindley C. Capecitabine: A Review. Clin Ther. 2005;27(1):23-44.
  3. Y, Hoff P. Management of hand-foot syndrome in patients treated with capecitabine (Xeloda). Eur J Oncol Nurs. 2004;8:31-40.
  4. Gutierrez-Pascual M, Sols-Candela M, Pinedo F, Lopez-Estebaranz JL. Toxic Dermatitis Due to Capecitabine: Presentation of 2 Cases and Literature Review. Actas Dermosifiliogr. 2009;100:329-343.
  5. Mignogna MG, Fortuna G, Falleti J, Leuci S. Capecitabine-induced stomatitis: a likely pathogenetic mechanism of oral lichenoid mucositis. Eur J Clin Pharmacol. 2009;65(10):1057-1059.
  6. Floristan U, Feltes RA, Sendagorta E, et al. Subacute cutaneous lupus erythematosus induced by capecitabine. Clin Exp Dermatol. 2009;34(7):e328-e329.
  7. Adachi A, Nagai H, Horikawa, T. Anti-SSA/Ro Antibody as a Risk Factor for Fluorouracil-Induced Drug Eruptions Showing Acral Erythema and Discoid- Lupus-Erythematosus-like Lesions. Dermatology. 2007;214:85-88.

Address for Correspondence

Alison Wiesenthal MDUniversity of Texas Health Science Center San AntonioSan Antonio, TXPhone: (210) 831-6367Fax: (409) 772-1943Email: alison.wiesenthal@gmail.com
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