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[Capecitabine-induced subacute cutaneous lupus: a case report]
J Fongue1, B Meunier2, D Lardet3
1Service de dermatologie, CHU La Timone, 13005 Marseille, France; Service de médecine interne, centre de compétence PACA Ouest pour la prise en charge des pathologies auto-immunes systémiques, CHU de la Conception, 147, boulevard Baille, 13005 Marseille, France.
Annales De Dermatologie Et De Venereologie
|October 8, 2014
Summary
Chemotherapy drug capecitabine can trigger subacute cutaneous lupus erythematosus (SCLE), even in patients with prior systemic lupus erythematosus (SLE). Discontinuation of capecitabine led to SCLE lesion resolution, confirming the drug-induced nature.
Area of Science:
- Dermatology
- Oncology
- Pharmacology
Background:
- Subacute cutaneous lupus erythematosus (SCLE) is associated with over 100 drugs, including certain chemotherapies.
- Distinguishing SCLE as a paraneoplastic syndrome versus a drug side effect is crucial for cancer treatment decisions.
Observation:
- A 50-year-old female with advanced colon cancer developed an itchy, photosensitive rash 4 months after starting capecitabine.
- The patient had a history of untreated, stable systemic lupus erythematosus (SLE) without prior skin involvement.
- Diagnosis of SCLE was confirmed by clinical presentation, anti-SSA antibodies, and histology.
Findings:
- Capecitabine (Xeloda) was identified as the likely cause of SCLE in this patient.
- SCLE lesions were resistant to hydroxychloroquine and systemic corticosteroids.
- Discontinuation of capecitabine resulted in the complete resolution of SCLE lesions.
Implications:
- Chemotherapy, specifically capecitabine, can induce or unmask SCLE, irrespective of a prior SLE diagnosis.
- Recognizing chemotherapy-induced SCLE is vital due to the increasing use of such agents in cancer therapy.
- This highlights the importance of pharmacovigilance for identifying rare but significant drug-induced adverse events.
