Gangrene of the fingertips after bleomycin and methotrexate.
The increased use of cytostatic drugs, which are sometimes used in combination chemotherapy, may result in new and unusual cutaneous side effects. We describe a 57-year-old man with acral erythrocyanosis progressing to acute digital ischemia and gangrene that developed after combined chemotherapy (bleomycin and methotrexate) used to treat a metastatic squamous cell carcinoma of the hypopharynx. A leukocytoclastic vasculitis was found in both the acute phase and in the amputated fingertips. This supports the well-reported potential of bleomycin to trigger acral vascular toxicity.
Correia
O
O
Department of Dermatology, Instituto Português de Oncologia, Porto, Portugal.
Ribas
F
F
Azevedo
R
R
Rodrigues
H
H
Delgado
L
L
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001761:Bleomycin / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D003490:Cyanosis / Q000139:chemically induced; D005385:Fingers / Q000473:pathology*; D005734:Gangrene / Q000139:chemically induced*; D006801:Humans; D007511:Ischemia / Q000139:chemically induced; D008297:Male; D008727:Methotrexate / Q000009:adverse effects; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000188:drug therapy
D001761:Bleomycin; D008727:Methotrexate