Bilateral Auricular Necrosis After Prolonged Self-Application of Topical 5-Fluorouracil

This case demonstrated a potential local adverse reaction of topical 5-fluorouracil (5-FU) usage. 5-FU is a topical chemotherapeutic drug often used in the management of dermatological conditions (including cutaneous malignancies). This case demonstrated the application of 5-FU to the bilateral pinnae, resulting in substantial necrosis. This case initially presented with concern for cutaneous malignancy, although malignancy was ruled out with biopsies, and medication side-effect etiology was strongly suggested by patient history and resolution following medication cessation. Management included debridement of necrotic auricular skin and soft tissue, with healing by secondary intention and acceptable cosmetic outcome. This case illustrated the importance of proper patient education and discussion when prescribing and managing topical chemotherapeutics.