A bilateral cicatricial ectropion and bilateral upper lid shortening caused by 5-fluorouracil toxicity in a patient with dihydropyrimidine dehydrogenase deficiency.
Cutan Ocul Toxicol
; 30(2): 157-9, 2011 Jun.
Article
in En
| MEDLINE
| ID: mdl-21077799
ABSTRACT
CONTEXT Well-known causes of a cicatrizing ectropion are chemical/thermal injuries, dermatitis, cutaneous diseases, malignancies, and trauma. We add to this preceding list a systemic cause of a cicatrizing ectropion as a result of a rare side effect of 5-fluorouracil (5-FU), a common and frequently used chemotherapeutic agent. METHODS:
A case report demonstrating the clinical presentation of a cicatricial ectropion caused by (5-FU) chemotherapy toxicity in a patient with dihydropyrimidine dehydrogenase deficiency. We also describe the subsequent investigations and management of this case.RESULTS:
A bilateral cicatrizing lower lid ectropion, bilateral upper lid shortening, cicatrizing and sclerosing facial skin changes occurred in an 80-year-old male, undergoing preoperative chemoradiotherapy, incorporating Capecitabine, an oral 5-FU prodrug for a locally advanced rectal carcinoma. Severe 5-FU toxicity ultimately proved fatal but in addition to typical 5-FU related adverse effects, the patient developed bilateral incomplete lid closure, secondary corneal exposure and keratopathy. Due to the patient's extreme ill health, he was managed conservatively with a moist chamber.CONCLUSION:
5-fluorouracil chemotherapy in patients with dihydropyrimidine dehydrogenase deficiency, can give rise to ocular and cutaneous toxicity. We also present the complex management problems that have to be anticipated in treating such systemically compromised patients.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ectropion
/
Dihydropyrimidine Dehydrogenase Deficiency
/
Fluorouracil
/
Antimetabolites, Antineoplastic
Limits:
Aged80
/
Humans
/
Male
Language:
En
Journal:
Cutan Ocul Toxicol
Journal subject:
DERMATOLOGIA
/
OFTALMOLOGIA
/
TOXICOLOGIA
Year:
2011
Document type:
Article
Affiliation country:
United kingdom
Publication country:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM