Department of Oncology, Kerala University of Health Science, IndiaFulltext PDF
Background: Capecitabine is an oral prodrug of 5-Fluorouracil (5-FU) which is converted to 5FU by a series of reactions which are catalyzed by different enzymes. The mechanism of action of capecitabine is the inhibition of DNA synthesis by the enzyme Thymidine Phosphorylase (TP). TP is found to be elevated in tumor cells in comparison to normal cells, thereby limiting its systemic toxicity. Although systemic toxicity is low, capecitabine can cause adverse reactions such as stomatitis, Hand Foot Syndrome (HFS), nausea, vomiting and rarely adermatoglyphia. Adermatoglyphia is a condition associated with loss of fingerprint. Case Report: We have reported a case of 65-year-old male patient suffering from rectosigmoid cancer. He had complaints of increased stool frequency for greater than 6 months and complaints of blood and mucus in stool for 3 months. CT scan of abdomen revealed a growth at rectosigmoid junction. The patient undergone anterior resection laparotomy surgery. After surgery, patient showed multiple tumor deposits in the mesocolon region. The patient was managed with chemotherapy with oxaliplatin 200 mg and Tab. Xeloda 500 mg 3 tablets in the morning and 2 tablets in the night for 21 days. At the cycle 3 patient was unable to register in one of the government programs due to loss of fingerprint. After completion of chemotherapy, radiation therapy was started along with Tab. Xeloda. Conclusion: As this case describes, patients receiving capecitabine have a rare chance for loss of fingerprint. There are other case reports which have reported that capecitabine associated adermatoglyphia is reversible i.e., the fingerprint will be normalized after stopping the therapy. Fingerprint is important as it is used for the identification purpose. There should be proper patient education for these patients and other alternative means of identification should be suggested.
Joseph SG. Loss of Fingerprint in a Rectosigmoid Cancer Patient with Grade 1 HFS: A Case Report and Literature Review. Oncol Case Report J. 2022; 5(2): 1050..