Gemcitabine-induced erysipeloid skin lesions in a patient with malignant mesothelioma

Our plain-English summary of Gemcitabine-induced erysipeloid skin lesions in a patient with malignant mesothelioma, by I. Kuku, E. Kaya, A. Sevinc, et al (Journal of the European Academy of Dermatology and Venereology, 2002).

The study

• Authors: I. Kuku, E. Kaya, A. Sevinc, I. Aydogdu
• Journal: Journal of the European Academy of Dermatology and Venereology
• Published: 2002;16(3):271-2
• Type of article: Case report
• Cited by: 31 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Gemcitabine is a nucleoside analogue that has shown to have antineoplastic activity in different solid tumours (lung, pancreas, bladder, colon, ovarian, and breast cancer) and malignant mesothelioma. The toxic effects of gemcitabine include myelosuppression, flu-like syndrome, altered liver function tests, bronchospasm, rash, itching, and fever. However, gemcitabine-induced erysipeloid skin reaction was reported in a small number of patients with previous history of radiotherapy or lymphedema. We reported a male patient who developed erysipeloid skin reaction following gemcitabine treatment in the absence of radiotherapy and lymphedema.

In plain English

This case report described one 50-year-old man in Turkey with malignant mesothelioma who developed skin reactions after treatment with the cancer drug gemcitabine. The article did not say where in the body the mesothelioma was, and it did not mention asbestos exposure. He had first received six courses of ifosfamide, daunorubicin and mesna, and he had no radiation therapy. When scans showed the cancer had spread to his liver, his treatment was switched to gemcitabine. Forty-eight hours after the infusion, two painful, itchy, reddish, warm patches about 10 by 10 cm appeared on his left elbow and right knee. They began fading a day after the drug was stopped and were gone by the fifth day. The same patches returned in the same places during each of the next two gemcitabine courses. His cancer kept growing, and treatment was stopped. Earlier reports had linked this reaction to past radiation or to lymphedema (swelling from poor lymph drainage). This patient had neither. The authors concluded that this was the first such case in the English literature and that doctors should keep this possible skin side effect of gemcitabine in mind.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report
• Who was studied: One 50-year-old man with malignant mesothelioma, diagnosed 6 months earlier, treated at Inonu University, Turgut Ozal Medical Center, Malatya, Turkey. The site of the mesothelioma is not stated.
• Exposure: The chemotherapy drug gemcitabine, 1000 mg/m2 (total dose 1800 mg), given intravenously every 4 weeks for three courses. Before this he had six courses of ifosfamide, daunorubicin and mesna. No asbestos exposure is described in the article.
• Main results:
  • 48 hours after the gemcitabine infusion, the patient developed two painful, itchy lesions about 10 by 10 cm on the left elbow and right knee.
  • The reddish, warm lesions faded a day after gemcitabine was stopped and were completely gone on the 5th day.
  • The lesions reappeared in the same areas during each of the following two gemcitabine courses.
  • The patient had no radiation therapy before or after chemotherapy, and no lymphedema.
  • After the third course, the liver metastases had grown and new spots had appeared in the spleen, so treatment was stopped.
• The authors' conclusion: The authors concluded that, to their knowledge, this was the first report in the English literature linking gemcitabine to erysipeloid skin lesions in a patient with no history of radiotherapy or lymphedema. They said this possible skin toxicity should be kept in mind when making treatment decisions.

Topics

Medical terms in this study, explained in our Lexicon: Gemcitabine, Malignant Mesothelioma.

Related studies

• Switch-maintenance gemcitabine after first-line chemotherapy in patients with malignant mesothelioma (NVALT19): an investigator-initiated, randomised, open-label, phase 2 trial — C.J. de Gooijer, V. van der Noort, et al. (2021)
• The role of gemcitabine in the treatment of malignant mesothelioma — H.L. Kindler, J.P. van Meerbeeck (2002)
• Gemcitabine reactivates epigenetically silenced genes and functions as a DNA methyltransferase inhibitor — S.G. Gray, A.M. Baird, et al. (2012)
• A phase II trial of prolonged, continuous infusion of low-dose gemcitabine plus cisplatin in patients with advanced malignant pleural mesothelioma — O. Arrieta, D. López-Macías, et al. (2014)
• A dose-finding study of gemcitabine and vinorelbine in advanced previously treated malignancies — J.P. Delord, E. Raymond, et al. (2000)
• A specific inhibitor of lactate dehydrogenase overcame the resistance toward gemcitabine in hypoxic mesothelioma cells, and modulated the expression of the human equilibrative transporter-1 — E. Giovannetti, L.G. Leon, et al. (2016)

Browse return to medical research.