Ahn HR, Lee SK, Youn HJ, Yun SK, Lee IJ. Stevens-Johnson syndrome and concurrent hand foot syndrome during treatment with capecitabine: A case report. World J Clin Cases 2021; 9(17): 4279-4284 [PMID: 34141791 DOI: 10.12998/wjcc.v9.i17.4279]
Corresponding Author of This Article
Hyun Jo Youn, MD, PhD, Chief Doctor, Surgeon, Division of Breast and Thyroid Surgery, Department of Surgery, Jeonbuk National University, 20 Gunji-ro, Jeonju 54907, South Korea. yhj0903@jbnu.ac.kr
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 16, 2021; 9(17): 4279-4284 Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4279
Stevens-Johnson syndrome and concurrent hand foot syndrome during treatment with capecitabine: A case report
Ha Rim Ahn, Sang-Kyung Lee, Hyun Jo Youn, Seok-Kweon Yun, Il-Jae Lee
Ha Rim Ahn, Hyun Jo Youn, Division of Breast and Thyroid Surgery, Department of Surgery, Jeonbuk National University, Jeonju 54907, South Korea
Ha Rim Ahn, Hyun Jo Youn, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, South Korea
Sang-Kyung Lee, Seok-Kweon Yun, Il-Jae Lee, Department of Dermatology, Jeonbuk National University Medical School, Jeonju 54907, South Korea
Author contributions: Ahn HR and Lee SK performed the case report and wrote the manuscript; Lee IJ, Ahn HR, edited the manuscript; Yun SK, Youn HJ supervised the work and edited the manuscript; all authors have read and approve the final manuscript.
Informed consent statement: This study was approved and reviewed by our Institutional Review Board.
Conflict-of-interest statement: The authors have no potential conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hyun Jo Youn, MD, PhD, Chief Doctor, Surgeon, Division of Breast and Thyroid Surgery, Department of Surgery, Jeonbuk National University, 20 Gunji-ro, Jeonju 54907, South Korea. yhj0903@jbnu.ac.kr
Received: January 15, 2021 Peer-review started: January 15, 2021 First decision: February 11, 2021 Revised: February 15, 2021 Accepted: April 20, 2021 Article in press: April 20, 2021 Published online: June 16, 2021 Processing time: 131 Days and 7.1 Hours
Abstract
BACKGROUND
Capecitabine is used in combination with lapatinib as palliative treatment for human epidermal growth factor receptor 2 - positive metastatic breast cancer. The most frequently reported adverse events attributed to capecitabine include diarrhea, hyperbilirubinemia, and hand-foot syndrome (HFS). A number of cutaneous adverse events have been attributed to capecitabine, including Stevens-Johnson syndrome (SJS) as a rare and potentially life-threatening mucocutaneous condition. We report the first case involving concurrent SJS and HFS after capecitabine and lapatinib treatment.
CASE SUMMARY
A 70-year-old woman with a history of breast cancer treatment visited our hospital for evaluation of painful skin lesions. Six weeks earlier, she had been prescribed capecitabine plus lapatinib as treatment for metastatic breast cancer. She subsequently developed worsening erythema and bullae on her palms and soles, as well as reddish macules on her back and chest wall. Histopathological evaluation of the chest wall lesions revealed extensive eosinophilic epidermal necrosis and separation of the epidermis from the dermis. The capecitabine plus lapatinib treatment was discontinued immediately and treatment was started using systemic steroids. This treatment resolved most lesions, although the lesions on her palms and soles required Vaseline gauze dressings, which resulted in re-epithelialization. Therefore, we determined that the patient had concurrent SJS and HFS. Although the dermatological problems resolved, the patient ultimately died because of multiple organ failure.
CONCLUSION
Oral capecitabine treatment carries a risk of both HFS and also life-threatening adverse cutaneous drug reactions, such as SJS.
Core Tip: Hand-foot syndrome (HFS) is a relatively well-known side effect of capecitabine treatment, although Stevens-Johnson syndrome (SJS) is not generally associated with capecitabine treatment. We report a case involving concurrent HFS and SJS. These side effects may decrease the patient's quality of life and delay chemotherapy for their primary disease. Therefore, clinicians should be aware of SJS as a rare side effect of capecitabine treatment and consider a multidisciplinary approach to treating this complication if necessary.
