Discrete Pigmentation After Chemotherapy

Abstract

Discrete areas of cutaneous hyperpigmentation were seen in two children with metastatic sarcoma who received chemotherapeutic bone marrow ablation with cyclophosphamide, etoposide, and carboplatin prior to autologous bone marrow transplantation. The hyperpigmented patches occurred only in areas of skin occluded by tape, electrocardiogram pads, or elastic bandages. Identical skin findings were reported in five adult women who received intravenous thiotepa and cyclophosphamide. Measurable levels of thiotepa were detected in these patients' serum, skin, sweat, and occluded gauze, suggesting that the chemical was excreted onto the skin surface in sweat and accumulated under occlusive dressing, thus producing some toxic effect on the epidermis or melanocytes resulting in abnormal pigmentation. We suspect that a similar mechanism was operative in our patients to produce the unusual patterned hyperpigmentation, and suggest that this complication may be prevented by minimizing sweat accumulation in areas occluded by adhesive materials.

Mitigating acute chemotherapy-associated adverse events in patients with cancer

“…Pigmentary changes. Benign changes in pigmentation have been observed with virtually all chemotherapeutic agents, most commonly with alkylating agents and antitumour antibiotics [203][204][205][206] . Enhanced skin pigmentation usually but not always resolves over time after the drug is stopped, although nail and mucosal changes can sometimes persist for years.…”

Reações tegumentares adversas relacionadas aos agentes antineoplásicos: parte II

“…Tables 2 and 3 show the drugs involved and the course of the adverse reaction. 6 There is no specific treatment for hyperpigmentation. The condition usually disappears some months or years after discontinuation of the drug that triggered the effect.…”