Uncommon Case of Vulvar Mucositis Following FOLFOX Treatment

Background

Vulvar mucocutaneous reactions during fluoropyrimidine-based chemotherapy are extremely rare. This case highlights the potential mucocutaneous toxicities associated with FOLFOX chemotherapy in female patients.

Data Highlights

No numerical data or trial data presented in the article.

Key Findings

• A 53-year-old woman developed acute vulvar mucocutaneous reaction after one cycle of mFOLFOX-6 chemotherapy.
• Initial treatment with low-potency topical steroid cream was ineffective, leading to the use of high-potency topical steroid cream, topical lidocaine, and topical vaginal estradiol.
• The 5-FU bolus was omitted from subsequent chemotherapy cycles, allowing completion of treatment without recurrence of vulvar symptoms.
• Vulvar mucocutaneous reactions during FOLFOX are exceedingly rare and not well-documented in the literature.
• Women may experience 5-FU-induced mucosal toxicity more frequently and severely than men.

Clinical Implications

Clinicians should be aware of the potential for rare mucocutaneous reactions in female patients receiving FOLFOX chemotherapy.

Conclusion

This case describes a rare mucocutaneous toxicity associated with fluoropyrimidine-based chemotherapy.

Related Resources & Content

1. Erythrodysesthesia of the Penile-Scrotal Area in Rectal Cancer Patients Undergoing Fluoropyrimidine-Based Chemoradiation: A Series of Case Reports, 2024
2. Patient-Reported Outcomes From the PROSPECT Trial: Neoadjuvant FOLFOX vs Chemoradiation for Locally Advanced Rectal Cancer, ASCO Post, 2023
3. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy, Cancer, 2020
4. The ASCO Post — Patient-Reported Outcomes From the PROSPECT Trial: Neoadjuvant FOLFOX vs Chemoradiation for Locally Advanced Rectal Cancer
5. Dermatology and Therapy (Springer) — A Prebiotic and Panthenol-Containing Repair Balm Improves Tolerability of Topical 5-Fluorouracil Field Therapy for Actinic Keratoses: A Randomised Controlled Trial
6. FDA Drug Label for Fluorouracil
7. Safety labeling update for capecitabine and fluorouracil (5-FU) on risks associated with dihydropyrimidine dehydrogenase (DPD) deficiency | FDA
8. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy - Elad - 2020 - Cancer - Wiley Online Library