Atypical moles in a patient undergoing chemotherapy with oral 5-fluorouracil prodrug.
We present a patient with multiple pigmented lesions on the palms, soles, oral mucosa and nails after chemotherapy with oral 5-fluorouracil (5-FU) prodrug. Dermoscopically, most of the macules showed similar features, with pigmentation present predominantly on the crista superficialis, while a large, dark macule also showed pigmentation along the sulcus superficialis with irregular hyperpigmentation and depigmentation, suggesting malignancy. However, histologically, both types of lesion showed basal hyperpigmentation and the presence of a small number of large atypical melanocytes. We diagnosed these lesions as pigment flecks induced by 5-FU, and the pigmented lesions gradually diminished after the cessation of chemotherapy. Our findings suggested that immunosuppression and 5-FU led to the development of the atypical pigmented lesions.
Fukushima
S
S
Division of Dermatology, Anamizu General Hospital, Fugeshi, Japan.
Hatta
N
N
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology*; D005472:Fluorouracil / Q000009:adverse effects*; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D008545:Melanoma / Q000175:diagnosis; D011355:Prodrugs / Q000009:adverse effects*; D012878:Skin Neoplasms / Q000175:diagnosis
D000964:Antimetabolites, Antineoplastic; D011355:Prodrugs; D005472:Fluorouracil