Widespread skin necrosis secondary to gemcitabine

Cutaneous side-effects are relatively common in chemotherapy but vary in frequency and severity depending on the medication, dose, duration, pharmacokinetics, and pharmacodynamics. Gemcitabine, a pyrimidine nucleoside analogue, is an oncologic agent used in the treatment of cutaneous T-cell lymphoma (CTCL). Common dermatologic reactions associated with gemcitabine include alopecia, mild skin rash, and mucositis. Rare reports of other cutaneous reactions include lower extremity skin necrosis, lower extremity pseudocellulitis, and scleroderma-like changes.