Serpentine Supravenous Hyperpigmentation, a Phenomenon Following the Administration of Chemotherapeutic Agents: A Systematic Review.

Background: Serpentine supravenous hyperpigmentation (SSH) is known as a phenomenon occurring during the infusion of chemotherapy agents in the underlying veins. Chemotherapy agents have potential to cause infusion reactions when used systematically. Linear hyperpigmentation and reticular hyperpigmentation are the differential diagnosis for this phenomenon. The aim of the present study was to systematically review the serpentine supravenous dermatitis induced by chemotherapeutic agents.

Methods: A comprehensive search was conducted in Scopus, PubMed, Embase, and Web of Science bibliometric databases on February 7, 2023. The search keywords were categorized into two groups: SSH and chemotherapy. Any combination between keywords was used for the systematic search. We included any type of article that evaluated the SSH in cancer patients after the infusion of chemotherapeutic agents, including observational studies with at least one eligible patient based on our criteria, case series, and case reports. Studies that reported SSH in non-cancer patients or caused by any medications other than chemotherapeutic agents were excluded.

Results: Twenty-five studies were included based on our inclusion criteria consisting of 26 patients. A total of 13 different cancers were reported in the included studies. Lung cancer was the most reported cancer. Also, the mostly reported region of this dermatitis was forearm which was reported in 13 studies. Docetaxel has been used in a total of 11 articles in this study and has independently induced serpentine supravenous dermatitis in seven studies, which is the mostly reported chemotherapeutic agent resulting into serpentine supravenous dermatitis. Most of these skin lesions were self-limiting and with a normal histopathological finding.

Conclusion: SSH is a dermatologic reaction, which mostly occur when there is peripheral venous access for the injection of chemotherapeutic agents. The skin lesion will improve spontaneously and have a benign course with no abnormal histopathological pathological finding.