Pemetrexed-Induced Pseudocellulitis: A Diagnostic Conundrum
Luke A Horton1, Alexis B Lyons2, Michael C Kwa2
1Dermatology, University of California Irvine, Irvine, USA.
Cureus
|February 12, 2024
Summary
Pemetrexed can cause a rare side effect called pemetrexed-induced pseudocellulitis (PIP), mimicking cellulitis. Early recognition of this adverse effect is crucial for proper patient management and avoiding unnecessary treatments.
Area of Science:
- Oncology
- Dermatology
- Pharmacology
Background:
- Pemetrexed is an anti-folate antineoplastic agent used for treating malignancies like non-small cell lung cancer (NSCLC) and mesothelioma.
- Adverse effects of pemetrexed can impact patient treatment and quality of life.
Observation:
- Two male patients, aged 60 and 47, presented with recurrent lower extremity erythema and edema.
- Both patients received multiple treatments for presumed cellulitis before the correct diagnosis was established.
Findings:
- The recurrent symptoms were diagnosed as pemetrexed-induced pseudocellulitis (PIP), a rare adverse effect of the chemotherapy agent.
- PIP was initially misdiagnosed as cellulitis, leading to delayed and inappropriate treatment.
Implications:
- Pemetrexed-induced pseudocellulitis (PIP) represents a significant diagnostic challenge for clinicians treating cancer patients.
- Awareness and early recognition of PIP can prevent misdiagnosis, reduce patient morbidity, and avoid unnecessary antibiotic use and hospitalizations.
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