{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T12:17:07Z","timestamp":1768825027688,"version":"3.49.0"},"reference-count":9,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000},"content-version":"unspecified","delay-in-days":51,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1478951524002177_sec1a\">\n\t    <jats:title>Objectives<\/jats:title>\n\t    <jats:p>The link between opioids and peripheral edema has been discussed in the literature, though scarcely, especially in case reports involving patients using transdermal fentanyl for pain management.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951524002177_sec2b\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>We present a case of a 51-year-old man with advanced head and neck cancer who developed severe, asymmetrical left-sided hemifacial edema following the initiation of transdermal fentanyl for pain management, which subsequently subsided after switching to transdermal buprenorphine.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951524002177_sec3c\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>We reduced the fentanyl patch from 75 to 62.5 mcg\/h. At a follow-up visit within 48 hours there was some improvement in the swelling of the eyelids and tongue, but no significant change was noted in the lips, chin, and cheek region; and the patient experienced facial pain and discomfort due to swelling. It was then decided to rotate the opioid to buprenorphine transdermal patch 52.5mcg\/h every 3 days; and a rapid improvement in the patient\u2019s face, particularly in the eyelids and cheek region was observed. The remaining edema with the buprenorphine patch could be due to cancer progression.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951524002177_sec4d\">\n\t    <jats:title>Significance of results<\/jats:title>\n\t    <jats:p>The final diagnosis of edema as a side effect of transdermal fentanyl was reached through careful knowledge of the frequent and non-frequent side effects of opioid drugs, clinical observation and, importantly, by listening to the patient and his wife, whose insights and observations were integrated with the medical team\u2019s knowledge and assessments. Our report enhances the benefit of paying close attention to the input and observations of patients and caregivers, as they are the ones most familiar with the disease\u2019s impact on daily life and the subtle changes and details that may go unnoticed in the clinical setting.<jats:sup>\u2021<\/jats:sup><\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s1478951524002177","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T05:42:14Z","timestamp":1740116534000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Asymmetric facial edema with transdermal fentanyl: when listening to patients and caregivers helps to diagnose"],"prefix":"10.1017","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0714-3058","authenticated-orcid":false,"given":"Carolina","family":"Sim\u00f5es","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9283-5045","authenticated-orcid":false,"given":"Miguel","family":"Juli\u00e3o","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6560-715X","authenticated-orcid":false,"given":"Patr\u00edcia","family":"Calaveiras","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"C\u00e2mara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8745-0412","authenticated-orcid":false,"given":"Eduardo","family":"Bruera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,2,21]]},"reference":[{"key":"S1478951524002177_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/0740-5472(91)90006-V"},{"key":"S1478951524002177_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(02)00404-9"},{"key":"S1478951524002177_ref7","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17312"},{"key":"S1478951524002177_ref6","doi-asserted-by":"publisher","DOI":"10.5114\/ain.2022.120785"},{"key":"S1478951524002177_ref8","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12443"},{"key":"S1478951524002177_ref9","volume-title":"The Principles and Practice of Medicine. 9th Edition","author":"Osler","year":"1920"},{"key":"S1478951524002177_ref2","first-page":"250","article-title":"Gabapentin-induced bilateral lower extremity edema in a patient with pervasive developmental disorder and schizoaffective disorder","volume":"10","author":"Finegan","year":"2020","journal-title":"The Mental Health Journal"},{"key":"S1478951524002177_ref1","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852923001736"},{"key":"S1478951524002177_ref3","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.121232"}],"updated-by":[{"DOI":"10.1017\/s1478951525000379","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T00:00:00Z","timestamp":1740096000000}}],"container-title":["Palliative and Supportive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1478951524002177","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T08:43:12Z","timestamp":1749112992000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1478951524002177\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":9,"alternative-id":["S1478951524002177"],"URL":"https:\/\/doi.org\/10.1017\/s1478951524002177","relation":{"correction":[{"id-type":"doi","id":"10.1017\/S1478951525000379","asserted-by":"object"}]},"ISSN":["1478-9515","1478-9523"],"issn-type":[{"value":"1478-9515","type":"print"},{"value":"1478-9523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e67"}}