Fingerprints have, for a long time, been more than of purely forensic significance. They have been recorded, for example, upon entering the USA, or they enable the unlocking of smartphones, notebooks etc. A report has now come from Iran concerning a 30-year old woman, whose fingerprint is no longer recognised by the fingerprint analyser at her place of work. Due to ovarian cancer, she had received postoperative paclitaxel (e.g. PACLITAXEL KABI) and carboplatin (e.g. CARBOPLATIN-GRY). After the 7th treatment cycle, reddening of the skin and abnormal sensation on the soles of the feet and the dorsal surfaces of the hands developed as a sign of hand-foot syndrome (palmoplantar erythrodysesthesia), but it did not affect her usual activities. However, 13 areas (minutiae) of her current finger lines no longer match those before the start of treatment. It would appear to be the first report of a fingerprint change in connection with paclitaxel. Symptomatic topical treatment with skin care products (emollients), betamethasone (BETNESOL-V, generics) ointment and sunscreen apparently led to a gradual improvement (1). However, there are also reports of suspected loss of finger lines in connection with the long-term external use of corticosteroids in the treatment of eczema (2).

This unusual adverse effect has been known for a longer time for the antimetabolite capecitabine (XELODA, generics) (3,4), which very often causes a severe hand-foot syndrome with blistering and peeling. An indication that this can also affect the fingerprint is not to be found, however, in current summary of product characteristics (SPC) (5). Changes and/or loss of finger lines may also be expected with other cancer drugs that are capable of causing hand-foot syndrome* (4). On the occasion of a report concerning a man treated with capecitabine, who, when entering the USA, was detained by customs for four hours due to erased fingerprints, an oncologist has recommended that affected patients should carry a letter with them to clarify the medical background of the problem (3).

1

AZADEH, P. et al.: Ann. Pharmacother. 2014; 48: 1249-50

2

SERGEANT, A. et al.: Clin. Experim. Dermatol. 2012; 37: 679-80

3

WONG, M. et al.: Ann. Oncol. 2009; 20: 1281; http://www.a-turl.de/?k=rich

4

AL-AHWAL, M.S.: Oncologist 2012; 17: 291-3; http://www.a-turl.de/?k=reuc

5

e.g. Roche: SPC XELODA, as at Jan. 2014

Hand-foot syndrome is to be expected very often (over 10%) with aflibercept (ZALTRAP), axitinib (INLYTA), cabozantinib (COMETRIQ), clofarabine (EVOLTRA), dabrafenib (TAFINLAR), fluorouracil (e.g. 5-FU-CELL), lapatinib (TYKERB), regorafenib (STIVARGA), sorafenib (NEXAVAR), sunitinib (SUTENT), trastuzumab (HERCEPTIN)and others. The atd drug database currently lists 32 active substances with mostly considerable potential to cause a hand-foot syndrome, -Ed.

Caution: less than five years on the market or under additional monitoring according to the European Medicines Agency