Syndrome de Stevens-Johnson induit par la capécitabine : à propos d’un cas avec revue de littérature

Abstract

Introduction

Capecitabine is an oral fluoropyrimidine carbamate, analog of 5-fluorouracil. It is widely used for many malignant tumors. Hand-foot syndrome is the most common dermatological toxicity associated with capecitabine and Stevens-Johnson syndrome is the rarest manifestation. We report a case of Stevens-Johnson syndrome induced by capicitabine.

Case presentation

A 49-year-old patient, hospitalized in oncology for the management of a mucinous colorectal adenocarcinoma with peritoneal metastases. He was treated with capecitabine 3500 mg per day. The patient presented diffuse pigmented lesions and an erosive scrotal lesion with dysphagia to solids and liquids, vomiting and non-bloody diarrhea, which occurred 5 days after the onset of the treatment. The clinical examination found an altered patient. The skin examination found a pigmented desquamative plaque on the face, diffuse atypical target lesions, a pigmented plaque on the palms of both hands, a scrotal erosion and cheilitis. The histology confirmed the diagnosis Stevens-Johnson syndrome. The pharmacovigilance declaration concluded that Stevens-Johnson syndrome was secondary to capecitabine according to chronological and bibliographic data. The patient died of respiratory distress.

Conclusion

Stevens-Johnson syndrome is a rare and serious complication that can occur, rarely, in patients treated with capecitabine. Our case is the 5th case of capecitabine-induced SJS that has been reported in the literature since 2008.