A Case Series of Different Dermatological Adverse Drug Reactions Attending the Medical Oncology Clinic of a Tertiary Care Hospital Eastern India

Abstract

Background:

Cutaneous adverse drug reactions (CADRs) are among the most frequent complications of anticancer therapy, affecting the skin, hair, nails, and mucosa. Both conventional cytotoxic chemotherapies and newer targeted agents are associated with a wide spectrum of dermatological toxicities that may impair quality of life and lead to dose modification or treatment discontinuation. Continuous pharmacovigilance is essential for early detection and appropriate management of these reactions as the safeguard of health by ensuring that the benefits of the use of the anticancer drugs outweigh the risk associated with its use.
Objectives:

To document and analyze the spectrum of dermatological adverse drug reactions in cancer patients receiving chemotherapy and targeted therapies at a tertiary care hospital in Eastern India, and to emphasize the role of pharmacovigilance in improving patient outcomes.
Methods:

This case series included ten patients who developed cutaneous adverse drug reactions while attending the Medical Oncology Clinic of a tertiary care hospital in Kolkata. Clinical details, suspected drugs, temporal association and dermatological manifestations were recorded. Causality assessment of the adverse events was performed based on clinical correlation and temporal relationship with drug administration.
Results:

Among the ten cases, females predominated (n=6). Five patients were above 40 years of age, while five were in the pediatric age group. Frequently implicated drugs included Paclitaxel, Capecitabine, L-asparaginase, Vincristine, Docetaxel, Doxorubicin, Cyclophosphamide, Daunorubicin, and Azacitidine. The observed CADRs comprised nail hyperpigmentation, palmoplantar hyperpigmentation, alopecia, oral ulcers, hyperpigmented plaques, skin nodules, acanthosis. Most reactions were non-life-threatening but contributed to patient distress and potential treatment interruptions.
Conclusion:

Cutaneous adverse drug reactions represent a significant proportion of adverse events associated with anticancer therapy. Early recognition, timely intervention, and close collaboration between oncologists and dermatologists are crucial to minimize morbidity and ensure treatment adherence. Strengthening Pharmacovigilance systems and maintaining robust ADR databases will enhance detection of emerging drug safety signals and optimize cancer patient care.