The Mysterious Case Of the Missing Fingerprints

A Singapore cancer patient arrived in the U.S. missing something very important -- his fingerprints. The man, identified only as Mr. S., was detained at airport customs for four hours until puzzled Homeland Security officials were able to verify his identity by other means, according to a letter posted online in ANNALS OF ONCOLOGY.

The loss of fingerprints is part of a condition known as hand-foot syndrome -- formally palmar-plantar erythrodysesthesia -- that arises in patients taking capecitabine (Xeloda), according to the man's doctor, of the Singapore National Cancer Centre. The syndrome causes chronic inflammation of the palms or soles of the feet and the skin can peel, bleed and develop ulcers or blisters. "This can give rise to eradication of finger prints with time.

The syndrome appears to be relatively common among capecitabine patients. One study, published in the JOURNAL OF CLINICAL PHARMACOLOGY in 2004, found that 65% of patients in clinical trials of the drug developed hand-foot syndrome, although only about5% had a grade 3 condition. Of those who develop the syndrome, only a few will lose their fingerprints, Dr. Tan told the Associated Press. Mr. S., who can't be identified for reasons of patient confidentiality, is a 62-year-old who was diagnosed with metastatic nasopharyngeal carcinoma and treated with a combination of cisplatin and 5-fluorouracil. After a near-complete response, he was started in July 2005 on maintenance capecitabine at 1,750 milligrams twice daily, two weeks on, one week off. Subsequently, his other doctors noticed that he had grade 2 hand-foot syndrome, "but as this did not affect his daily activities and function, he was kept on the same maintenance dose," they said. Then, last December, Mr. S. decided to visit relatives in the U.S.

When he reached U.S. immigration he was asked to provide images of the prints on his two index fingers and could not, triggering the "inconvenience."

Primary source: Annals of Oncology
Source reference:
Wong M, et al "Travel warning with capecitabine" ANN ONCOL 2009; DOI: 10.1093/annonc/mdp278.

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