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Related Experiment Videos

Cutaneous recall reactions with systemic fluorouracil.

M E Kirkup1, S Narayan, C T C Kennedy

  • 1Bristol Dermatology Centre, Bristol Royal Infirmary, Bristol, UK. maggie.kirkup@btinternet.co.uk

Dermatology (Basel, Switzerland)
|February 20, 2003
PubMed
Summary

Systemic 5-fluorouracil can cause inflammation on normal skin, particularly in patients with sun damage or prior topical treatment. Prophylactic topical steroids can prevent recurrence, avoiding unnecessary chemotherapy discontinuation.

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Area of Science:

  • Oncology
  • Dermatology
  • Pharmacology

Background:

  • 5-Fluorouracil (5-FU) is a chemotherapy agent commonly used for actinic keratoses due to its selective uptake by rapidly dividing cells, causing localized inflammation.
  • Systemic administration of 5-FU is primarily for treating various cancers, including oesophagogastric junction and lower oesophageal carcinomas.

Observation:

  • Two cases are presented where patients developed inflammation on clinically normal skin following parenteral 5-FU administration for oesophageal cancer.
  • In one case, the patient had a history of topical 5-FU treatment for actinic keratoses; the other had significant sun exposure without prior actinic keratoses.
  • Both patients responded well to topical steroid application for the inflammatory reaction.

Findings:

  • Inflammation on normal skin, distinct from the intended therapeutic effect on lesions, can occur with systemic 5-fluorouracil.

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  • Previous topical 5-FU treatment or significant sun exposure may predispose individuals to this reaction.
  • Prophylactic topical steroid treatment prevented recurrence of skin inflammation during subsequent systemic 5-FU doses.

    • Implications:

    • Recognizing this non-allergic inflammatory reaction is crucial for clinicians.
    • Preventing unnecessary discontinuation of essential chemotherapy drugs like 5-fluorouracil is vital for patient treatment outcomes.
    • Topical steroids can be an effective prophylactic measure against 5-FU-induced skin inflammation.