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Perforating folliculitis, angioedema, hand-foot syndrome--multiple cutaneous side effects in a patient treated with

Carola Wolber1, Astrid Udvardi, Georg Tatzreiter

  • 1Donauspital SMZ Ost, Department of Dermatology and Venereology, Vienna, Austria. Carola.Wolber@wienkav.at

Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
|January 31, 2009
PubMed

Insights

Sorafenib, a multikinase inhibitor, can cause skin side effects like angioedema, hand-foot syndrome, and perforating folliculitis. These reactions appear dose-dependent, improving with reduced sorafenib dosage.

Area of Science:

  • Oncology
  • Dermatology
  • Pharmacology

Background:

  • Sorafenib is a multikinase inhibitor used to treat clear cell renal cell carcinoma.
  • Cutaneous side effects are common with sorafenib treatment.
  • Understanding these adverse events is crucial for patient management.

Observation:

  • A patient receiving sorafenib for renal cell carcinoma experienced xerosis, angioedema (AE), hand-foot syndrome (HFS), and perforating folliculitis (PF).
  • The onset and severity of AE, HFS, and PF demonstrated a dose-dependent relationship.
  • AE occurred at 800 mg, HFS at 400 mg, and PF at 200 mg, with improvements upon dose reduction.

Findings:

  • This case highlights the dose-dependent nature of sorafenib-induced cutaneous toxicities.
  • Angioedema, hand-foot syndrome, and perforating folliculitis were observed sequentially with decreasing sorafenib doses.
  • This is the first reported instance of perforating folliculitis associated with sorafenib therapy.

Implications:

  • Clinicians should monitor for specific cutaneous side effects during sorafenib treatment.
  • Dose adjustments may be necessary to manage sorafenib-induced dermatologic toxicities.
  • Awareness of these potential side effects, including the rare PF, can guide treatment decisions and improve patient outcomes.

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