Unusual pigmentary changes associated with 5-fluorouracil therapy

A fifty-six year old black man with stage D carcinoma of the prostate was treated weekly with 5-fluorouracil 750 mg/m2 for twenty-four consecutive doses. The total amount received was 27 gm. A good partial remission was attained. Little hematologic and no gastrointestinal or central nervous system toxicity was experienced. The patient did experience nasal mucosal friability and diffuse hyperpigmentation of the face and hands. Markedly increased pigmementation of skin immediately overlying veins used for multiple 5-fluorouracil infusions was noted. Because of its unusual appearance, the name serpentine supravenous fluorouracil hyperpigmentation is suggested for this entity.