Weird ADRs: Capecitabine and fingerprints

All drugs have some sort of side effect. But some are just plain weird.

Take for example the case of  a 62-year-old male, Mr S who had head and neck cancer that had spread (metastatic nasopharyngeal carcinoma), but which had responded well to chemotherapy. To help prevent a recurrence of the cancer the patient was put on a maintenance dose of capecitabine.

Mr S developed a mild case of hand and foot syndrome which is an adverse effect of the drug. This is chronic inflammation of the palms or soles of the feet.The skin can peel, bleed and develop ulcers or blisters. This can give rise to eradication of finger prints with time. As his symptoms were mild Mr S was kept on his maintainance dose of capecitabine.

Mr S had been on capecitabine for 3 years when he decided to visit his relatives in he USA. He was detained at airport customs for 4 hours because the immigration officers could not detect his fingerprints. He was allowed to enter after the custom officers were satisfied that he was not a security threat.

He was advised to travel with a letter from his oncologist stating his condition and the treatment he was receiving to account for his lack of fingerprints to facilitate his entry in future.

As pharmacists we need to be aware of how side effects can affect peoples lives. This is an extreme example of just that.