Tegafur-induced acral hyperpigmentation

Tegafur is a prodrug of 5-fluorouracil (5-FU) with a similar spectrum of antitumor activity. It is used in the treatment of advanced gastrointestinal neoplasms. Over 5-FU, tegafur has the advantage of oral administration and less hematologic toxicity. Gastrointestinal toxicity is its main dose-limiting factor. The cutaneous adverse effects of tegafur include mucositis, photosensitivity, diffuse or nail-restricted hyperpigmentation, palmoplantar erythrodysesthesia syndrome, palmoplantar keratoderma, sclerodactyly and Raynaud phenomenon. We report here the case of a patient who developed acral hyperpigmentation during treatment with tegafur.