RESUMEN
Capecitabine is a prodrug used primarily as a chemotherapeutic agent. Despite its good tolerance, it has several adverse effects, including the appearance of eruptive nevi. We present the case of a patient, with a history of EC IV breast adenocarcinoma and superficial extension melanoma, which developed 2 weeks after the start of therapy with capecitabine multiple eruptive palmoplantar pigmented lesions, with diverse benign dermatoscopic patterns. With the increasing incidence of solid tumors, these agents are being more used. It is important that the treating physician knows its adverse effects and apply non-invasive diagnostic tools like dermoscopy to avoid unnecessary biopsies.
La capecitabina es un profármaco utilizado sobre todo como medicamento quimioterapéutico. A pesar de su buena tolerancia, produce diversos efectos adversos como la aparición de nevos eruptivos. Se presenta el caso de una paciente, con antecedentes de adenocarcinoma de mama (EC IV) y melanoma de extensión superficial, que desarrolló dos semanas posteriores al inicio del tratamiento con capecitabina múltiples lesiones eruptivas pigmentadas palmoplantares, con patrones variados benignos a la dermatoscopia. Con el incremento de las neoplasias sólidas, estos agentes se utilizan cada vez más. Es importante que el médico tratante conozca sus efectos adversos y aplique herramientas diagnósticas no invasivas como la dermatoscopia para evitar biopsias innecesarias.
Asunto(s)
Antimetabolitos Antineoplásicos/efectos adversos , Capecitabina/efectos adversos , Dermoscopía , Erupciones por Medicamentos/diagnóstico por imagen , Dermatosis del Pie/inducido químicamente , Dermatosis de la Mano/inducido químicamente , Adenocarcinoma , Antimetabolitos Antineoplásicos/uso terapéutico , Neoplasias de la Mama , Capecitabina/uso terapéutico , Diagnóstico Diferencial , Erupciones por Medicamentos/etiología , Femenino , Dermatosis del Pie/diagnóstico por imagen , Dermatosis de la Mano/diagnóstico por imagen , Humanos , Melanoma/diagnóstico , Melanoma/tratamiento farmacológico , Persona de Mediana Edad , Neoplasias Primarias Secundarias/tratamiento farmacológico , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/tratamiento farmacológicoRESUMEN
A 42-year-old man presented with a six-month history of a slowly-enlarging ulcer on his right sole, a 30-year history of altered pigmentation of the trunk and extremities, and hyperkeratotic papules of the palms and soles. Histopathologic examination showed an invasive squamous-cell carcinoma of the right sole and hyperkeratosis with keratinocyte atypia of the left finger and left lateral foot. The clinical and histopathologic findings are consistent with chronic arsenicism, which most commonly occurs in the setting of drinking contaminated water or after occupational exposure. Evaluation should include a physical examination, basic laboratory work-up, and measurement of a 24-hour urine arsenic concentration. Vigilant surveillance for the development of cutaneous malignancies is required. Oral retinoids may be helpful in reducing hyperkeratosis secondary to chronic arsenicism.