Document Type


Publication Date



This article has been peer reviewed. It was published in: Journal of the American Academy of Dermatology

Volume 69, Issue 4, pages: 643-645 October 2013

The published version is available at DOI: 10.1016/j.jaad.2013.04.034. Copyright © Elsevier Inc.



A 37-year-old man with a slightly raised, red, scaly patch on his left arm is seen in the clinic of an academic teaching hospital by a young dermatologist. Following examination and biopsy, he is found to have squamous cell carcinoma in situ. The patient was recently laid off from work and had lost access to his health insurance. He is struggling to make ends meet for his family, so it would be difficult for him to cover any extraneous health-related expenses. Upon relaying this information to the dermatologist, the patient is provided with a full course of 5-fluorouracil (topical cream 5%) from the clinic’s sample cabinet. Later in the day, it is discovered that the same batch of drugs has been outdated for more than 4 months. Because the dermatologist was only recently hired, she worries that she will be severely reprimanded for her failure to inspect the expiry date.

The dermatologist should:

A. Not do anything because the drug sample was only recently outdated, and the risk for adverse outcomes may be considered to be relatively low.

B. Report the incident to a more senior dermatologist right away, and let that person ameliorate the situation.

C. Call the patient as soon as possible to warn him of possible dangers of using outdated drugs, and offer prompt exchange for a new sample.

D. Inform the patient of the potential risks associated with outdated drugs, promptly apologize, and make a sincere effort to regain the patient’s trust.

PubMed ID


Included in

Dermatology Commons