ABSTRACT
El apremilast es un fármaco inhibidor de la fosfodiesterasa-4 que modula, a nivel intracelular, la expresión de citoquinas involucradas en la patogenia inflamatoria de la psoriasis. Su uso está indicado en la psoriasis en placas moderada y severa, con buenos resultados clínicos. Los principales efectos adversos son gastrointestinales y, en menos del 2% de los pacientes, dermatológicos, con exantema y foliculitis. Se presenta el caso de un paciente de 42 años que, luego de tomar el apremilast, desarrolló lesiones faciales que correspondieron clínica e histopatológicamente a una reacción acneiforme, con evolución favorable y resolución total del cuadro posterior a la suspensión del medicamento.
Apremilast is a phosphodiesterase-4 inhibitor that modulates the intracellular expression of cytokines, which are involved in the pathogenesis of psoriasis. Apremilast is indicated in moderate to severe plaque psoriasis, and it has shown good clinical results. The main adverse effects occur at a gastrointestinal level, and in less than 2% at the dermatologic level with exanthema and folliculitis. We present a 42-year-old patient that developed facial lesions after taking apremilast. The facial lesions were clinically and histopathologically correspond to an acneiform eruption. The patient evolved favorably and fully recovered after suspending apremilast.
Subject(s)
Humans , Male , Adult , Psoriasis/drug therapy , Thalidomide/adverse effects , Thalidomide/analogs & derivatives , Acneiform Eruptions , Diarrhea , Minocycline/administration & dosageABSTRACT
Dacomitinib (PF-00299804) is a newly developed irreversible pan-HER (human epidermal growth factor receptor) inhibitor for the treatment of non-small cell lung cancer (NSCLC). Inhibiting HER-1 (epidermal growth factor receptor, EGFR), HER-2, and HER-4 may induce similar cutaneous side effects to those of traditional EGFR inhibitors. We report two patients who developed acneiform eruption on the face and trunk, induced by dacomitinib treatment for NSCLC. The skin lesions appeared 3~4 weeks after the initiation of dacomitinib use, and they improved after oral minocycline and topical clindamycin treatment. There has been no report of acneiform eruption after dacomitinib treatment in Korean dermatology journals.
Subject(s)
Humans , Acneiform Eruptions , Carcinoma, Non-Small-Cell Lung , Clindamycin , Dermatology , Drug Therapy , Epidermal Growth Factor , Minocycline , SkinABSTRACT
Dacomitinib (PF-00299804) is a newly developed irreversible pan-HER (human epidermal growth factor receptor) inhibitor for the treatment of non-small cell lung cancer (NSCLC). Inhibiting HER-1 (epidermal growth factor receptor, EGFR), HER-2, and HER-4 may induce similar cutaneous side effects to those of traditional EGFR inhibitors. We report two patients who developed acneiform eruption on the face and trunk, induced by dacomitinib treatment for NSCLC. The skin lesions appeared 3~4 weeks after the initiation of dacomitinib use, and they improved after oral minocycline and topical clindamycin treatment. There has been no report of acneiform eruption after dacomitinib treatment in Korean dermatology journals.
Subject(s)
Humans , Acneiform Eruptions , Carcinoma, Non-Small-Cell Lung , Clindamycin , Dermatology , Drug Therapy , Epidermal Growth Factor , Minocycline , SkinABSTRACT
BACKGROUND: Epidermal growth factor receptor (EGFR) inhibitors are associated with cutaneous adverse events, including papulopustular eruption, xerosis, paronychia, hair abnormality and mucositis. In particular, acneiform eruptions might serve as the visible markers of anti-tumor activity and the therapeutic efficacy of EGFR inhibitors. OBJECTIVE: Our aims are to investigate the common cutaneous adverse events induced by cetuximab, which is one of the EGFR inhibitors approved by the US Food and Drug Administration, and to analyze whether the presence and severity of papulopustular eruptions have a correlation with the tumor response. METHODS: We retrospectively reviewed the medical records and clinical photographs of 114 Korean patients who had been treated with cetuximab at Asan Medical Center from September 2004 to March 2007. Results: Papulopustular eruptions occurred in 100 patients (87.7%) and this usually happened 10 days after starting chemotherapy. There was a tendency that the better the tumor responded to the chemotherapeutic agents including cetuximab, the more severe were the papulopustular eruptions. The papulopustular eruptions prominently improved after the treatment with topical agents such as benzoyl peroxide, metronidazole, clindamycin and retinoid, and with systemic agents such as minocycline and tetracycline, and there was no adverse event induced by this treatment for papulopustular eruptions. Xerosis appeared in 67 patients (58.8%), and there was a tendency that the more severe papulopustular eruptions were, the more frequently xerosis occurred. Paronychia occurred in 8 patients (7.0%). CONCLUSION: Although the cutaneous adverse events are burdensome to the patients, they might serve as visible markers of the anti-tumor activity and therapeutic efficacy of cetuximab and they can be easily and safely controlled with many topical and systemic agents. Therefore, it is important for dermatologists to properly treat these cutaneous adverse events and to reassure the patient to continue with the cetuximab treatment.
Subject(s)
Humans , Acneiform Eruptions , Antibodies, Monoclonal, Humanized , Benzoyl Peroxide , Clindamycin , Drug Therapy, Combination , Hair , Medical Records , Metronidazole , Minocycline , Mucositis , Paronychia , ErbB Receptors , Retrospective Studies , Tetracycline , United States Food and Drug Administration , CetuximabABSTRACT
Epidermal growth factor has an important role in the regulation of proliferation and differentiation in epidermal keratinocytes, as well as in the survival, angiogenesis and metastasis of cancer cells. Cetuximab is a chimeric monoclonal antibody selective for the epidermal growth factor receptor that induces a broad range of cellular responses that enhance tumor sensitivity to radiotherapy and chemotherapeutic agents. However, it can cause adverse events in the patient including acneiform eruption, asthenia, abdominal pain and nausea/vomiting. We report a case of severe acneiform eruption induced by cetuximab in a 56-year-old man with colorectal cancer and liver metastases.
Subject(s)
Humans , Male , Middle Aged , Acneiform Eruptions/chemically induced , Antibodies, Monoclonal/adverse effects , Antineoplastic Agents/adverse effects , Colorectal Neoplasms/drug therapy , Liver Neoplasms/drug therapyABSTRACT
Erlotinib (Tarceva(R)) is a new anti-cancer agent which acts by inhibiting epidermal growth factor receptor (EGFR) signal transduction. It is currently used in the treatment of advanced stage non-small cell lung cancer and pancreatic cancer. We report a case of acneiform eruption and paronychia induced by erlotinib in a 69-year-old man. The patient visited our clinic with multiple erythematous papules and pustules on the face, periungual erythema and pus discharge, xerosis, fissures on the sole. He had taken erlotinib for the treatment of recurred lung cancer for 4 weeks. The skin lesions were partially improved with oral pyridoxine, corticosteroid and topical antibiotics.
Subject(s)
Aged , Humans , Acneiform Eruptions , Anti-Bacterial Agents , Carcinoma, Non-Small-Cell Lung , Erythema , Lung Neoplasms , Pancreatic Neoplasms , Paronychia , Pyridoxine , ErbB Receptors , Signal Transduction , Skin , Suppuration , Erlotinib HydrochlorideABSTRACT
We report a case of acneiform skin eruption induced by cetuximab in a 58-year-old man. Cetuximab is a new anticancer agent, which acts as a selective epidermal growth factor receptor monoclonal antibody. Our patient had taken cetuximab for the treatment of metastatic rectal cancer and visited our clinic with multiple erythematous papules and pustules on the face, postauricular area and anterior chest. A skin biopsy from his forehead revealed destruction of the follicular structure and perifollicular inflammatory cellular infiltrations composed of neutrophils and lymphocytes.
Subject(s)
Humans , Middle Aged , Acneiform Eruptions , Biopsy , Forehead , Lymphocytes , Neutrophils , ErbB Receptors , Rectal Neoplasms , Skin , Thorax , CetuximabABSTRACT
BACKGROUND: ZD1839 (Iressa(R)Gefitinib) is an orally active, selective epidermal growth factor (EGF) receptor tyrosine kinase inhibitor that blocks signal production pathways in cell proliferation. It is currently used in the treatment of advanced stage non-small cell lung cancer. Cutaneous side effects commonly associated with ZD 1839 treatment include acneiform eruption, dry skin and hair growth abnormalities. Cutaneous eruptions result from direct interference with functions of EGF receptor signaling in the skin. OBJECTIVE: The purpose of our study was to investigate the clinical features of cutaneous side effects of ZD 1839 in Korean with literature review. We also analysed the relationship between skin rash severity, onset and objective tumor response. METHOD: We retrospectively reviewed medical records and the histologic materials of 23 Korean patients who had been treated with ZD 1839 at Ajou University Hospital from March 2002 to September 2003 . RESULTS: The results are summarized as follows. 1. The most common cutaneous side effect was acneiform skin rash (56%) which is a well known complication of ZD 1839. 2. Acneiform eruptions were easily controlled by oral antibiotics, such as minocycline and topical retinoid ointment. 3. The second common side effect was dry scaly skin (43%). 4. We also found acute paronychia, finger tip desquamation, alopecia and intertrigo. 5. The severity of the skin rash correlated well with the treatment response of ZD 1839. 6. When the skin rash appeared within 1 week after taking ZD 1839, the skin rash was severe, and the tumor responded well to the ZD 1839. CONCLUSION: The results of this study suggest that acneiform eruption and dry skin are the most common cutaneous side effects of ZD 1839. The association between rash severity and onset of tumor response suggests that the rash may serve as a marker of response to ZD1839 therapy and may be used to guide treatment to obtain optimal response. However, further prospective studies on the potentially important association between rash severity or onset and outcome of treatment with ZD 1839 are needed.
Subject(s)
Humans , Acneiform Eruptions , Alopecia , Anti-Bacterial Agents , Carcinoma, Non-Small-Cell Lung , Cell Proliferation , Epidermal Growth Factor , Exanthema , Fingers , Hair , Intertrigo , Medical Records , Minocycline , Paronychia , Protein-Tyrosine Kinases , ErbB Receptors , Retrospective Studies , SkinABSTRACT
We report cutaneous adverse effects developed in three patients and are probably related to Iressa(R)(Gefitinib, ZD1839) medication. Iressa(R) is a new anti-cancer agent which acts by inhibiting epidermal growth factor (EGF) receptor signal transduction. The three patients had all taken Iressa(R) for treatment of non-small cell lung cancer and came to our clinic with cutaneous adverse effects. All three patients had acneiform eruptions, and one of the patients also had periungal granulation lesions. Histopathologically, periadnexal inflammatory cellular infiltrations were seen in the acneiform lesions of the three patients and granulation-like tissue proliferations in periungal granulation lesions of the one patient.
Subject(s)
Humans , Acneiform Eruptions , Carcinoma, Non-Small-Cell Lung , Epidermal Growth Factor , Signal TransductionABSTRACT
ZD1839 (Iressa(R)) is a new anticancer agent, a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor that blocks signal transduction pathway implicated in the proliferation and survival of cancer cells and other host-dependent process promoting cancer growth. But this agent can induce cutaneous side effects including acneiform eruption, dry skin, and hair abnormality, which is related with the interruption of normal epidermal and hair follicular kinetics. We report a case of hair change and acneiform eruption induced by ZD1839 (Iressa(R)).
Subject(s)
Acneiform Eruptions , Hair , Kinetics , Protein-Tyrosine Kinases , ErbB Receptors , Signal Transduction , SkinABSTRACT
Epidermal growth factor (EGF) has an important role in the regulation of the proliferation and differentiation of epidermal keratinocytes, as well as in the survival, angiogenesis and metastasis of various cancer cells. There have been some reports of acneiform skin lesions that occurred in the cancer patients treated with ZD1839(Iressa(R)), an inhibitor of EGF tyrosine kinase. We report a case of acneiform eruption related to the anticancer drug, ZD1839(Iressa(R)).
Subject(s)
Humans , Acneiform Eruptions , Epidermal Growth Factor , Keratinocytes , Neoplasm Metastasis , Protein-Tyrosine Kinases , SkinABSTRACT
Iressa(R) (ZD1839) is a new anticancer agent, acting as a selective epidermal growth factor receptor tyrosine kinase inhibitor. Iressa(R) has been generally well-tolerated in cancer patients. Predominant adverse effects are an acne-like skin rash, diarrhea, nausea, vomiting, dry skin, and mild to moderate myelosuppression. The side effect of paronychia or alopecia is rare. We report a case of paronychia with granulation tissue induced by Iressa(R). Our patient complained of an acneiform eruption on his face and xerosis on his left arm and both feet as well as paronychia of several finger and toe nails.