title: Radiation recall dermatitis with soft tissue necrosis following pemetrexed therapy: a case report.
abstract: BACKGROUND
  Radiation recall dermatitis is a well known but still poorly understood inflammatory reaction. It can develop in previously irradiated areas and has been shown to be triggered by a variety of different drugs, including cytostatic agents. Pemetrexed may cause radiation recall dermatitis in pre-irradiated patients.
  
  
  METHODS
  We present the case of a 49-year-old Caucasian woman with non-small cell lung cancer who was initially treated with carboplatin and paclitaxel concomitant with radiotherapy after suffering a painful plexus brachialis infiltration. Due to disease progression, a second-line treatment with pemetrexed was started. A severe soft tissue necrosis developed despite steroid treatment and plastic surgery.
  
  
  CONCLUSIONS
  To the best of our knowledge, we present the first case of a patient with severe soft tissue necrosis in a pre-irradiated area after pemetrexed therapy. We believe that physicians treating patients with pemetrexed should be aware of the severe, possibly life-threatening effects that may be induced by pemetrexed after previous radiation therapy.
authors: Department of Oncology-Hematology, Cantonal Hospital, St.Gallen, Switzerland.
authors: Christian
authors: C
authors: Spirig
authors: Aurelius
authors: A
authors: Omlin
authors: Giannicola
authors: G
authors: D'Addario
authors: Klaus-Dieter
authors: KD
authors: Loske
authors: Philipp
authors: P
authors: Esenwein
authors: Jan Henning
authors: JH
authors: Geismar
authors: Thomas
authors: T
authors: Ruhstaller