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Cutaneous drug eruptions induced by sorafenib: a case series

Jessica S Maddox1, Elaine F Kung, Vesna Petronic-Rosic

  • 1University of Chicago, Department of Medicine, Section of Dermatology, Chicago, IL, USA. jessica.maddox@uchospitals.edu

Journal of Drugs in Dermatology : JDD
|December 31, 2008
PubMed

Insights

Sorafenib, a targeted cancer therapy, can cause significant skin reactions in patients. This study details four cases of drug eruptions, including facial erythema and palmoplantar erythrodysesthesia, linked to sorafenib treatment.

Area of Science:

  • Oncology
  • Dermatology
  • Pharmacology

Background:

  • Sorafenib is a targeted therapy inhibiting Raf kinases and receptor tyrosine kinases involved in tumor growth and angiogenesis.
  • It is approved for advanced renal cell carcinoma and investigated for other solid tumors.
  • Epidermal growth factor receptors (EGFR) are key in cell signaling, and their inhibition is a therapeutic strategy.

Observation:

  • Four patients developed diffuse erythematous eruptions 8-10 days after starting sorafenib (400 mg twice daily).
  • Clinical presentations included facial and generalized macular erythema, follicular papular eruptions, and palmoplantar erythrodysesthesia.
  • Half experienced cutaneous eruptions without systemic effects; the other half had hypersensitivity reactions requiring trial withdrawal.

Findings:

  • This case series is the first to illustrate drug eruptions specifically induced by sorafenib.
  • The observed eruptions share similar clinical and histopathological characteristics.
  • Skin reactions varied in severity, from localized rashes to systemic hypersensitivity.

Implications:

  • Dermatologists should be aware of potential sorafenib-induced cutaneous adverse events.
  • Early recognition and management of these eruptions are crucial for patient safety and treatment adherence.
  • Further research is needed to understand the mechanisms and optimal management of sorafenib dermatopathies.

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