A case of capecitabine-induced discoid lupus erythematosus = A case of capecitabine-induced discoid lupus erythematosus

다국어 초록 (Multilingual Abstract)

There are a few reports of capecitabine-induced cutaneous lupus erythematosus (CLE), of which most of are subacute CLE. In particular, only one case showed discoid lupus erythematosus (DLE)-like features. Capecitabine is an oral fluoropyrimidine carbamate designed to generate 5-fluorouracil preferentially in tumor tissue through exploitation of higher intratumoral concentrations of thymidine phosphorylase and has less systemic toxicity than 5-fluorouracil administered through intravenous processes. The occurrence of druginduced CLE is related to the use of the drug in a timely manner, followed by the improvement of skin symptoms after discontinuation of the offending drug within several weeks. Stopping implicated medication is the initial management of drug-induced CLE. We report an interesting case of oral capecitabine-induced DLE with discoid and malar rashes, which had not occurred using LF protocol (leucovorin plus 5-fluorouracil) previously, that could not be provoked after changing chemotherapy from a capecitabine (a pro-drug of 5-fluorouracil) to FOLFIRI regimen containing leucovorin, 5-fluorouracil, and irinotecan. This case is meaningful for considering the unknown metabolic components acting on converting capecitabine to 5-fluorouracil of CLE induced by oral capecitabine.