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Semi-automatic PD-L1 Characterization and Enumeration of Circulating Tumor Cells from Non-small Cell Lung Cancer Patients by Immunofluorescence
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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
PubMed
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.

Keywords:
cellulituscomplex medical dermatologydermatologydrug reactioninfectious cellulitisinpatient dermatologyoncodermatologypemetrexedpseudocellulitissupportive onco-dermatology

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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.