Ectropion following topical 5-fluorouracil treatment

Area of Science:

• Dermatology
• Ophthalmology

Background:

• Topical 5-fluorouracil (5-FU) is a widely used chemotherapeutic agent for treating actinic keratoses (AKs).
• Common side effects include local inflammatory reactions such as erythema, erosions, and ulcerations.
• Systemic intolerance and contact dermatitis are also potential adverse events.

Observation:

• A case study involving a 78-year-old female patient is presented.
• The patient developed unilateral ectropion, a condition affecting the eyelid margin.
• This adverse event occurred subsequent to the application of topical 5-fluorouracil.

Findings:

• Topical 5-fluorouracil application can lead to rare but significant ocular side effects.
• Unilateral ectropion was observed as a direct consequence of the medication's application in this case.
• The mechanism may involve inflammatory or irritant effects on the delicate eyelid structures.

Implications:

• Clear and comprehensive patient counseling is crucial when prescribing topical 5-fluorouracil.
• Patients must be instructed on meticulous hand hygiene after application to prevent accidental transfer.
• Emphasizing avoidance of the orbital rim, eyes, and eyelids is essential to mitigate risks of ocular adverse events.