Eyelid and feet edema induced by pemetrexed

Abstract

Pemetrexed is an anti-metabolite that targets multiple enzymes in folate pathway. The main toxicities associated with pemetrexed are asthenia, nausea, diarrhea, myelosuppression, and rash. Few cases of pemetrexed induced cutaneous adverse event have been reported, mainly periorbital-facial edema and edema of the limbs. We report a case of pemetrexed-induced edema of the eyelid and feet in a patient with adenocarcinoma of the lung.

Pemetrexed-Induced Pseudocellulitis: A Diagnostic Conundrum

“…Grade 1-2 peripheral edema (without erythema) occurs in approximately 4.5% of NSCLC patients receiving pemetrexed [9]. However, PIP should be considered when this edema presents with erythema [2,[10][11][12]. The exact mechanism for PIP is unknown; however, it may be due to increased capillary protein leakage similar to that seen in docetaxel therapy [11].…”

“…However, PIP should be considered when this edema presents with erythema [2,[10][11][12]. The exact mechanism for PIP is unknown; however, it may be due to increased capillary protein leakage similar to that seen in docetaxel therapy [11]. Others suggest an etiology similar to eosinophilic cellulitis (Wells syndrome), where a hypersensitivity reaction occurs against pemetrexed accumulating in the skin [3].…”