Venous extravasation of doxorubicin HCl with secondary skin ulceration

With increased use of the potent anticancer drug doxorubicin HCl (Adriamycin), there are increasing numbers of reports of local severe tissue damage at the venous administration sites. I have described a 70-year-old woman in whom extravasation of this drug produced a characteristic indolent ulcer on the hand and wrist. Expectant nonoperative care was followed six weeks later by debridement and a split-thickness skin graft which failed to take. Repeat debridement with porcine grafts stimulated granulation tissue, so that split-thickness skin grafting could give an acceptable functional and cosmetic result.