Raltitrexed-induced skin reaction

Background. Raltitrexed (Tomudex(R)) is a thymine synthetase inhibitor used for first line treatment of metastatic colorectal cancer. Skin reactions w ere reported in the preclinical trials but have never been documented in cl inical practice. We report the first two cases. Case reports. Two patients, aged 75 and 65 years, were given raltitrexed fo r adenocarcinoma of the rectum for the first case and of the sigmoid for th e second. Both developed a skin reaction 5 and 7 days after onset of treatm ent. These patients had erythromatous edematous and purpuric skin reactions associated with asthenia, diarrhea and moderate fever. The skin lesions we re painful and pseudo-cellulitic. They were generalized in the first case a nd localized on the legs in the second. The reactions subsided in both case s 15 days after drug withdrawal after a desquamation phase. Conclusion. We report the first two cases of raltitrexed-induced pseudo-cel lulitic skin reactions.