A case of gemcitabine-related acute lipodermatosclerosis

J Oncol Pharm Pract. 2019 Jul;25(5):1271-1274. doi: 10.1177/1078155218788709. Epub 2018 Jul 24.

Abstract

Introduction: Gemcitabine is a chemotherapeutic agent used to treat several solid organ malignancies. The most common cutaneous toxicities are a mild erythematous rash and pruritus, which are often attributed to infectious etiologies. However, certain clinical characteristics may favor a drug-related reaction. Clinicians should recognize these phenomena to avoid potentially unnecessary antibiotic treatment or withdrawal of chemotherapeutic agents.

Objective: We aim to report a case of gemcitabine-related acute lipodermatosclerosis-like eruption, add to the evolving classification of this condition, and highlight developing literature on gemcitabine that may explain this toxicity.

Case: Dermatology was consulted for presumed cellulitis in a 62-year-old female with pancreatic carcinoma. The patient presented to the emergency department five days after her first dose of gemcitabine with erythema in both lower extremities. A diagnosis of gemcitabine-related acute lipodermatosclerosis was made and the patient was started on topical triamcinolone.

Conclusion: It is important to recognize gemcitabine-related acute lipodermatosclerosis in order to avoid unnecessary antibiotic use and disruptions in chemotherapy.

Keywords: Acute lipodermatosclerosis; cellulitis; erysipeloid; gemcitabine; pseudocellulitis.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Antimetabolites, Antineoplastic / adverse effects*
  • Deoxycytidine / adverse effects
  • Deoxycytidine / analogs & derivatives*
  • Dermatitis
  • Female
  • Gemcitabine
  • Humans
  • Middle Aged
  • Pancreatic Neoplasms / drug therapy*
  • Scleroderma, Localized / chemically induced*

Substances

  • Antimetabolites, Antineoplastic
  • Deoxycytidine
  • Gemcitabine

Supplementary concepts

  • Lipodermatosclerosis