A Case report of recurrent worsening vitiligo in cancer patient treated with capecitabine

Abstract

Background: Capecitabine is the novel chemotherapeutic agent commonly indicated for colorectal and breast cancer Because of its mild toxicity and its oral route of administration, there were many ongoing studies using capecitabine in patients with several types of malignancies especially of gastrointestinal organs. Common cutaneous toxicities from capecitabine reported include palmar-plantar erythrodysesthesia or hand-foot syndrome, cutaneous hyperpigmentation and xerosis of the skin. The clinical association between capecitabine and cutaneous vitiligo has never been reported elsewhere.

Observations: We presented a 55 years old female patient with previously known case of vitiligo receiving capecitabine for cancer treatment and developed recurrence of vitiligo with more widespread involvement than her initial presentation.

Conclusions: This is the first report of recurrent worsening vitiligo in capecitabine treated patient. The pathogenesis is not truly known. We hypothesized that, with the underlying melanocytic susceptibility to oxidative stress in our patient, the level of cellular oxidative stress to melanocyte caused by capecitabine during the course of chemotherapy might aggravate systemic melanocytic dysfunction with clinical presentation of widespread vitiligo.