A study of mucocutaneous manifestations due to cancer chemotherapy

Background. Recently, increasing numbers of chemotherapeutic agents are being used to treat cancer patients. Mucocutaneous complications are commonly seen in association with the administration of these medications. Objective. We conducted a study in cancer chemotherapy patients to determine the suspected chemotherapeutic agents and frequency of various mucocutaneous side effects in these patients. Methods. The study involved 140 patients admitted from December 1993 to September 1994 for cancer chemotherapy at Korea University Guro Hospital. Results. The mucocutaneous side effects during chemotherapy were alopecia (55%), hyperpigmentation (32.9%), stomatitis (20%), phlebitis (12.9%), flushing (8.6%) in descending order. Visual grade II, IV alopecia patients were most common, but as the chemotherapy cycle increased so, the severer the alopecia. Although the onset of the alopecia were variable, many patients experienced alopecia within 17 to 24 days after the start of chemotherapy. Serpentine supravenous fluorouracil hyperpigmentation were common (17.9%). Diffuse and longitudinal or horizontal band like nail pigmentation were observed, and pigmented macules were also observed especially on the palms and digits. Stomatitis usually developed within 10 days after the start of chemotherapy and it persisted for about 7 days and then most of the lesions were resolved spontaneously. Other clinical manifestations accompanied with chemotherapy were tinea infection (16.4%), acne (7.1%), oral thrush (7%), white nail band (4.3%), pruritus (2.9%) in descending order. Conclusion. So, physicians need to be aware of the widely divergent cutaneous reactions which may occur with the use of anticancer medications.