Skin necrosis from extravasation of Vinorelbine

• Published in: Journal of the European Academy of Dermatology and Venereology Vol. 16; no. 5; pp. 488 - 490
• Main Authors: Moreno de Vega, MJ, Dauden, E, Abajo, P, Bartolome, B, Fraga, J, Garcia‐Diez, A
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.09.2002
• Subjects: Aged; Antineoplastic Agents, Phytogenic - adverse effects; Breast Neoplasms - pathology; Carcinoma, Non-Small-Cell Lung - drug therapy; extravasation; Extravasation of Diagnostic and Therapeutic Materials; Female; Forearm; Humans; Infusions, Intravenous - adverse effects; Lung Neoplasms - drug therapy; Lung Neoplasms - secondary; Male; Middle Aged; Necrosis; Skin - drug effects; skin necrosis; Vinblastine - administration & dosage; Vinblastine - adverse effects; Vinblastine - analogs & derivatives; vinorelbine
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1046/j.1468-3083.2002.00564.x

Skin necrosis from intravenous infiltration of soft tissue is a rare but potentially devastating complication of intravenous therapy. Vinca alkaloids are among the intravenous drugs with the highest destructive power. We report two cases of skin necrosis from accidental extravasation of vinorelbine, a semisynthetic analogue of vinblastine, rarely described as being responsible for this event. Histopathologic study showed separation of the dermis from necrotic epidermis, associated with cytologic atypia, in both patients, and focal necrosis of eccrine glands in one of them. We consider that intravenous infusions of vinorelbine should be performed using the preventive measures and care applied for other chemotherapeutic agents with high potential for induction of skin necrosis due to extravasation.