Pigmented Lesions of Buccal and Labial Mucosa in a Patient Treated by Capecitabine (Xeloda): A Case Report

One of the most common adverse reactions associated with usage of the chemotherapeutic oral prodrug capecitabine is Hand-foot syndrome (HFS) identified by hyperpigmentation of hands and feet, which is considered as the initial manifestation of this syndrome. The sudden appearance of multiple melanocytic lesions in patients undergoing chemotherapy with capecitabine, in sites other than hands and feet, has been previously described on the skin of the ear and neck [1] and the mucosa of tongue [2]. Although mucosal focal pigmentation on the tongue has been described in combination with palmar-plantar associated pigmented lesions [2-4], the involvement of buccal and labial mucosa has not been yet reported following initiation of chemotherapy with capecitabine. We describe the pigmented lesions of buccal and labial mucosa in a 67 year-old patient diagnosed with breast carcinoma and treated by capecitabine.