title: Gemcitabine-induced extensive skin necrosis.
abstract: An 82-year-old woman presented with oedema and extensive necrotic ulcerative lesions on the back side of her lower limbs, emerging after the second cycle of chemotherapy consisting of Gemcitabine for metastatic pancreatic cancer. The absence of any convincing argument in favor of cardiovascular or autoimmune disease led us to attribute the onset of skin necrosis to chemotherapy administration. Although skin ischemia has also been described as a paraneoplastic syndrome, in this case we could observe a temporal and causal relationship to Gemcitabine infusion. Recently, this drug has been associated with important vascular side effects; its vascular toxicity is in fact higher than previously estimated. To our knowledge, careful attention should be reserved to neoplastic patients candidated to Gemcitabine administration, especially if previously affected by arterial vascular disease, venous thromboembolism, or collagenoses.
authors.affiliation: Dipartimento di Dermatologia, Policlinico Umberto I, "Sapienza" Università di Roma, Viale del Policlinico 155, 00160 Roma, Italy ; Dipartimento di Scienze Radiologiche, Oncologiche e Anatomo-Patologiche Policlinico Umberto I, "Sapienza" Università di Roma, Viale del Policlinico 155, 00160 Roma, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: D'epiro
authors.forename: Monica
authors.initials: M
authors.lastname: Salvi
authors.forename: Carlo
authors.initials: C
authors.lastname: Mattozzi
authors.forename: Simona
authors.initials: S
authors.lastname: Giancristoforo
authors.forename: Marco
authors.initials: M
authors.lastname: Campoli
authors.forename: Ramona
authors.initials: R
authors.lastname: Zanniello
authors.forename: Cecilia
authors.initials: C
authors.lastname: Luci
authors.forename: Laura
authors.initials: L
authors.lastname: Macaluso
authors.forename: Sara
authors.initials: S
authors.lastname: Giovannoni
authors.forename: Roberto
authors.initials: R
authors.lastname: Iacovelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Calvieri
authors.forename: Antonio Giovanni
authors.initials: AG
authors.lastname: Richetta