Case report
Occurrence of subacute cutaneous lupus erythematosus after treatment with fluorouracil and capecitabine

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Capecitabine, an oral fluoropyrimidine and 5-fluorouracil (FU) prodrug recently approved for the treatment of metastatic colon and breast cancer, is currently under investigation in patients with gastric cancer. It has the advantage of oral administration, and good tolerability with its activity being comparable with intravenous 5-FU. Lupus erythematosus and lupuslike drug eruptions have been observed after 5-FU treatment, but so far no cases of subacute cutaneous lupus erythematosus have been described in patients treated either with capecitabine or 5-FU. We report a patient who developed subacute cutaneous lupus erythematosus after administration of 5-FU and capecitabine.

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Case report

A 77-year-old woman presented at our department of dermatology with a 3-week history of erythematosquamous plaques on her face, lower aspect of her arms, and back of her hands. A diagnosis of advanced gastric cancer had been made in March 2005 and 3 cycles of chemotherapy with leucovorin, 5-FU, and etoposide had been administered. After the first cycle the patient had noticed cervical erythema, which resolved within the next 2 weeks. Cervical and facial erythematous rash again re-evolved during

Discussion

SCLE is a clinically and immunologically distinct subset of lupus erythematosus characterized by erythematous, nonscarring, papulosquamous or annular lesions in a photosensitive distribution (eg, arms, upper aspect of chest, and back).5 Among others, diuretics, antihypertensives (eg, calcium channel blockers, angiotensin-converting enzyme inhibitors, and beta blockers), acid blockers, nonsteroidal anti-inflammatory drugs, and recently terbinafine have been implicated in precipitating SCLE.5, 6

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Funding sources: None.

Conflicts of interest: None declared.

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