吉西他滨化疗致双下肢硬皮病样改变

Scleroderma-like changes of both lower extremities caused by gemcitabine chemotherapy

1例63岁女性患者因卵巢癌术后复发接受吉西他滨(1.2 g静脉滴注,第1天)联合卡铂(500 mg静脉滴注,第2天)方案化疗。第1次化疗结束后,患者即发生双下肢轻微水肿及刺痛,脚踝至小腿中部皮肤渐变淡红色;随后刺痛感及水肿逐渐减轻,表皮逐渐增厚。第2次化疗后,患者双下肢皮肤刺痛和水肿加重。化疗间歇期,刺痛症状和水肿逐渐减轻,但双下肢皮肤颜色逐渐变成深棕色,表皮增厚、变硬,呈典型硬皮病样改变。第3次化疗后,下肢刺痛及水肿再次加重,随后患者失访。因患者既往曾接受紫杉醇脂质体联合卡铂化疗6次,无皮肤损伤发生,故考虑患者的硬皮病样改变与吉西他滨有关。

A 63-year-old female patient received gemcitabine(1.2g by an Ⅳ infusion on the first day)and carboplatin combination chemotherapy(500mg by an Ⅳ infusion on the second day)because of postoperative recurrence of ovarian cancer.After finishing the first chemotherapy,the patient had slight ede-ma and stabbing pain of both legs,and the skin from ankle to the middle of both legs gradually turned red-dish.Then the stabbing pain and edema were gradually relieved and the epidermis was gradually thickened.Afer finishing the second chemotherapy,the skin stabbing pain and edema of both lower extremities were aggravated.During the interval of chemotherapy,the stabbing pain and edema were gradually reduced,but the skin of her legs gradually turned dark brown,the epidermis became thick and hard,showing lypical scleroderma-like changes.After finishing the third chemotherapy,the stabbing pain and edema of the lower extremities were aggravated again.Then the patient was lost to ollow-up.No skin injury occurred during 6 times of paclitaxel liposome and carboplatin combination chemotherapy.So the scleroderma-like changes in the patient was considered to be related to gemcitabine.