Serpentine supravenous hyperpigmentation.

Serpentine supravenous hyperpigmentation is a peculiar cutaneous eruption that follows the path of vein after intravenous injection of the chemotherapeutic agent. The lesions gradually resolve spontaneously if administration of the offending agent is stopped through the affected limb. Drugs such as 5-fluorouracil, docetaxel, vinorelbine, hydroxychloroquine, fotemustine, and minocycline are implicated.

A 30‐year‐old Asian Indian woman with history of breast cancer has presented with blackish discoloration above the site of intravenous access on right forearm [Fig. 1A] after 1 week of infusion of docetaxel through a peripheral venous catheter. She was recently started on palliative single agent chemotherapy with docetaxel 75 mg/m2 for metastatic disease and did not have a central venous port. We diagnosed the rash as serpentine supravenous hyperpigmentation secondary to docetaxel. In addition, she was also noted to have other dermatologic manifestations of docetaxel, namely blackish discoloration of the palms [Fig. 1C], horizontal banding and pigmentation of nails [Fig. 1B], and alopecia 1, 2, 3, 4.

Figure 1

(A) Hyperpigmentation along the superficial veins of the forearm. (B) Horizontal banding and pigmentation of nails. (C) Blackish discoloration of the palms.

Authorship

All the authors made substantial contribution to the preparation of this manuscript and approved the final version for submission. IJ: procured the images and drafted manuscript; HM: drafted manuscript; AK: reviewed and revised the manuscript for critically important intellectual content.

Conflict of Interest

The authors have declared that no conflict of interest exists.

Informed Consent

Informed consent has been obtained for the publication of this clinical image.