NEJM:氟尿嘧啶诱导的色素沉着-病例报道

2020-01-23 xing.T MedSci原创

皮肤色素沉着是多种化学疗法药物的副作用,包括氟尿嘧啶;停止治疗后病情会有所改善。

患者为一名3b期结肠癌的57岁男子,到肿瘤内科接受辅助化疗而就诊。七个星期前,他接受了右半结肠切除术,病理学检查发现中度分化的腺癌,19处结肠淋巴结中有2处淋巴结转移阳性。该患者开始使用FOLFOX(亚叶酸[亚叶酸]、氟尿嘧啶和奥沙利铂)进行化学疗法。

两个周期后,他注意到手掌逐渐变黑,不伴有发红、结垢或疼痛。脚底部分受到的影响很小,其余皮肤正常。在第三轮化疗后,这些病变恶化了(如图A所示)。除了手掌色素沉着恶化以外,还出现了4级中性粒细胞减少和3级疲劳,并终止了化疗。



皮肤色素沉着是多种化学疗法药物的副作用,包括氟尿嘧啶;停止治疗后病情会有所改善。

患者停止化疗后一个月,色素沉着明显减轻,停药两个月后,他的手掌恢复到接近正常的外观(如图B所示)。
 
原始出处:

Jordan K. Schaefer,et al.Fluorouracil-Induced Hyperpigmentation.N Engl J Med 2020;https://www.nejm.org/doi/full/10.1056/NEJMicm1909329

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    2020-03-20 sunylz
  2. [GetPortalCommentsPageByObjectIdResponse(id=1680653, encodeId=b8f4168065337, content=<a href='/topic/show?id=9e5c86e0712' target=_blank style='color:#2F92EE;'>#色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86707, encryptionId=9e5c86e0712, topicName=色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=343027846633, createdName=sunylz, createdTime=Fri Mar 20 09:37:00 CST 2020, time=2020-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1542857, encodeId=7c88154285edd, content=<a href='/topic/show?id=64fe63923be' target=_blank style='color:#2F92EE;'>#氟尿嘧啶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63923, encryptionId=64fe63923be, topicName=氟尿嘧啶)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a8ca13497099, createdName=12498710m15暂无昵称, createdTime=Sat Jan 25 00:37:00 CST 2020, time=2020-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035095, encodeId=999d1035095af, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jan 23 12:37:00 CST 2020, time=2020-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378428, encodeId=129d3e84281f, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Thu Jan 23 11:40:54 CST 2020, time=2020-01-23, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1680653, encodeId=b8f4168065337, content=<a href='/topic/show?id=9e5c86e0712' target=_blank style='color:#2F92EE;'>#色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86707, encryptionId=9e5c86e0712, topicName=色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=343027846633, createdName=sunylz, createdTime=Fri Mar 20 09:37:00 CST 2020, time=2020-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1542857, encodeId=7c88154285edd, content=<a href='/topic/show?id=64fe63923be' target=_blank style='color:#2F92EE;'>#氟尿嘧啶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63923, encryptionId=64fe63923be, topicName=氟尿嘧啶)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a8ca13497099, createdName=12498710m15暂无昵称, createdTime=Sat Jan 25 00:37:00 CST 2020, time=2020-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035095, encodeId=999d1035095af, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jan 23 12:37:00 CST 2020, time=2020-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378428, encodeId=129d3e84281f, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Thu Jan 23 11:40:54 CST 2020, time=2020-01-23, status=1, ipAttribution=)]
    2020-01-23 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1680653, encodeId=b8f4168065337, content=<a href='/topic/show?id=9e5c86e0712' target=_blank style='color:#2F92EE;'>#色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86707, encryptionId=9e5c86e0712, topicName=色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=343027846633, createdName=sunylz, createdTime=Fri Mar 20 09:37:00 CST 2020, time=2020-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1542857, encodeId=7c88154285edd, content=<a href='/topic/show?id=64fe63923be' target=_blank style='color:#2F92EE;'>#氟尿嘧啶#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63923, encryptionId=64fe63923be, topicName=氟尿嘧啶)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a8ca13497099, createdName=12498710m15暂无昵称, createdTime=Sat Jan 25 00:37:00 CST 2020, time=2020-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035095, encodeId=999d1035095af, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jan 23 12:37:00 CST 2020, time=2020-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=378428, encodeId=129d3e84281f, content=很好的学习机会, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Thu Jan 23 11:40:54 CST 2020, time=2020-01-23, status=1, ipAttribution=)]
    2020-01-23 一天没事干

    很好的学习机会

    0

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