Pellagra secondary to 5-fluorouracil.
The development of pellagra in a patient treated with 5-fluorouracil for malignant disease is reported. The aetiology of pellagra in this patient is discussed, and the reasons for possible under-diagnosis of pellagra in association with malignant disease considered. We report a patient who presented with the typical skin changes of pellagra. The rash, and an associated acute deterioration in cerebral function, were exacerbated by treatment with 5-fluorouracil. The importance of considering nicotinic-acid deficiency in patients with malignant disease has not been emphasized in the literature.
Stevens
H P
HP
Department of Dermatology, Royal Free Hospital and School of Medicine, London, U.K.
Ostlere
L S
LS
Begent
R H
RH
Dooley
J S
JS
Rustin
M H
MH
D000368:Aged; D001661:Biliary Tract Neoplasms / Q000188:drug therapy; D005472:Fluorouracil / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D009539:Nicotinic Acids / Q000627:therapeutic use; D010383:Pellagra / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D012867:Skin / Q000473:pathology
D009539:Nicotinic Acids; D005472:Fluorouracil