Leukocytoclastic vasculitis associated with capecitabine

Area of Science:

• Oncology
• Dermatology
• Pathology

Background:

• Leukocytoclastic vasculitis (LCV) is a systemic inflammation of small blood vessels.
• Anticancer therapies, including chemotherapy, can trigger vasculitis.
• Capecitabine-induced LCV is an uncommon but significant adverse event.

Observation:

• A 70-year-old male with locally advanced rectal cancer (LARC) received neoadjuvant capecitabine and radiation.
• Within seven days of initiating capecitabine, the patient developed a characteristic rash.
• Histopathological examination confirmed leukocytoclastic vasculitis.

Findings:

• The patient's rash resolved upon discontinuation of capecitabine.
• Re-challenge with a lower capecitabine dose, combined with oral corticosteroids, allowed for successful treatment completion.
• This case demonstrates the successful management of capecitabine-induced LCV.

Implications:

• Highlights the importance of recognizing rare adverse drug reactions in cancer patients.
• Suggests that capecitabine dose modification and corticosteroid therapy can manage LCV.
• Underscores the need for vigilance regarding potential side effects of widely used chemotherapeutic agents.