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November 6, 2019

Capecitabine-Related Eruption Mimicking Dermatomyositis in 2 Patients With Metastatic Breast Cancer

Author Affiliations
  • 1Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 2Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 3Center for Cutaneous Oncology, Department of Dermatology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
JAMA Dermatol. Published online November 6, 2019. doi:https://doi.org/10.1001/jamadermatol.2019.3162

Capecitabine, a prodrug of fluorouracil, is an oral chemotherapeutic agent used to treat various types of malignant tumors. Several cutaneous adverse events have been reported with its use, including hand-foot syndrome (HFS), onycholysis, paronychia, pigmentary changes, fingerprint loss, and subacute cutaneous lupus erythematosus.1-4 The incidence of HFS with capecitabine use is 50% to 60% and is dose related.2,4,5 It usually presents within the first 3 cycles of treatment with palmoplantar dysesthesia that progresses to symmetric, well-demarcated erythema and edema, which are most pronounced over the fat pads of fingers and toes.2,3,5 We report 2 cases of women with metastatic breast cancer who developed an eruption on the dorsal side of the hands mimicking dermatomyositis while receiving treatment with capecitabine.

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