TLDR Topical 5-Fluorouracil can rarely cause nerve damage, especially in people with a certain genetic deficiency.
Topical 5-Fluorouracil (5-FU), used for treating skin growths, can rarely cause neurotoxic effects, as demonstrated in an 83-year-old male who developed focal neurotoxicity, including paralysis and pain, after using 5-FU cream. This case suggests a link between the drug and neurologic symptoms, particularly in patients with a genetic deficiency in dihydropyrimidine dehydrogenase (DPD), which is crucial for 5-FU metabolism. Providers should be aware of these potential side effects to better counsel and manage patients.
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