Toxic Epidermal Necrolysis and Antifolate Drugs in Cancer Chemotherapy

Title:Toxic Epidermal Necrolysis and Antifolate Drugs in Cancer Chemotherapy

Volume: 7 Issue: 5

Author(s): Claudine Pierard-Franchimont, Marianne Lesuisse, Philippe Humbert, Philippe Delvenne and Gerald E. Pierard

Affiliation:

Keywords: Antifolate, methotrexate, pemetrexed, cancer, folate metabolism, toxic epidermal necrolysis, Stevens-Johnson syndrome, Folates, necrosis, lymphocytes, macrophages

Abstract: Folates are one-carbon donors essential for synthesizing purines, pyrimidines, serine, and methionine. They correspond to anionic hydrophilic molecules essential for DNA synthesis in mammalian cells. The latter cells lack the capacity to synthesize folates. In some patients, high dosages of antifolate drugs (eg: methotrexate, pemetrexed) used in cancer chemotherapy alter the keratinocytes, endothelial cells and Factor XIIIa+ dermal dendrocytes in a range of various severities. Such conditions clinically designed under the heading antifolate cytotoxic skin reaction (ACSR) occasionally resemble the toxic epidermal necrolysis (TEN) / Stevens-Johnson syndrome (SJS) spectrum. Whether or not the TEN/SJS presentation of ACSR is a regular condition similar to that induced by other drugs or a variant condition supported by a unique pathomechanism is unsettled.

Cite this article as:

Pierard-Franchimont Claudine, Lesuisse Marianne, Humbert Philippe, Delvenne Philippe and E. Pierard Gerald, Toxic Epidermal Necrolysis and Antifolate Drugs in Cancer Chemotherapy, Current Drug Safety 2012; 7 (5) . https://dx.doi.org/10.2174/1574886311207050005