Subject(s)
Hair Follicle , Hair Removal/adverse effects , Patch Tests/adverse effects , Urticaria/etiology , Female , Humans , Middle AgedSubject(s)
Lymphadenopathy/diagnostic imaging , Lymphadenopathy/etiology , Patch Tests/adverse effects , Patch Tests/methods , Thiazoles/adverse effects , Adult , Axilla/diagnostic imaging , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/etiology , Female , Hand Dermatoses/diagnosis , Hand Dermatoses/etiology , Humans , Nail Diseases/diagnosis , Nail Diseases/etiology , UltrasonographyABSTRACT
No disponible
Subject(s)
Humans , Male , Aged, 80 and over , Skin Neoplasms/diagnosis , Neoplasm Metastasis/diagnosis , Melanoma , Skin Neoplasms/secondary , Lymphatic Metastasis , Lower Extremity/pathologySubject(s)
Lymphatic Metastasis , Melanoma/secondary , Skin Neoplasms/secondary , Aged, 80 and over , Biopsy , Humans , Leg , Male , Nevus, Pigmented/pathology , Skin Neoplasms/pathologyABSTRACT
BACKGROUND: A 66-year-old woman with metastatic mammary carcinoma, who was being treated with capecitabine, contracted a herpes zoster infection that was treated with the antiviral drug brivudin. A drug-drug interaction between brivudin and capecitabine caused medullar aplasia, serious toxic effects to the intestinal mucous membrane, hand-foot syndrome, onycholysis and dental pigmentation. INVESTIGATIONS: Physical examination, blood analysis, blood cultures, chest X-ray, bone marrow aspiration and biopsy. DIAGNOSIS: Serious adverse event secondary to inhibition of dihydropyrimidine dehydrogenase by a drug-drug interaction between capecitabine and brivudin. MANAGEMENT: Intravenous hydration, imipenem, red blood cell and platelet transfusions, filgrastim, omeprazole, care of the mouth and feet, topical anesthetics, systemic analgesics and parenteral nutrition.