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[Leg ulcerations and sunitinib]

P Guyot-Caquelin1, F Granel-Brocard, J-F Cuny

  • 1Hôpital Fournier, Nancy, France. p.caquelin@yahoo.fr

Annales De Dermatologie Et De Venereologie
|October 12, 2010
PubMed
Abstract

Insights

Sunitinib, a cancer drug, may cause leg ulcers. This case report shows ulcers improved when the drug was stopped and returned when it was restarted, even at a lower dose.

Area of Science:

  • Oncology
  • Vascular Medicine
  • Dermatology

Background:

  • Sunitinib is a tyrosine kinase inhibitor used for metastatic renal cancer and gastrointestinal stromal tumors (GIST).
  • Antiangiogenic therapies can impact wound healing and tissue integrity.
  • The role of targeted cancer therapies in drug-induced dermatological conditions requires further investigation.

Observation:

  • A 73-year-old female patient with a history of deep venous thrombosis developed painful leg ulcers during sunitinib treatment for metastatic renal cancer.
  • The leg ulcers resolved upon discontinuation of sunitinib.
  • Ulcer recurrence was observed upon re-challenge with sunitinib, even at a reduced dosage.

Findings:

  • The patient's leg ulcers showed a clear temporal relationship with sunitinib administration.
  • The improvement of ulcers after drug withdrawal and their recurrence upon re-challenge suggest a causal link.
  • The non-dose-dependent recurrence indicates a potential idiosyncratic or non-linear mechanism.

Implications:

  • Sunitinib may induce or exacerbate leg ulcers, potentially due to its antiangiogenic properties.
  • Clinicians should monitor for and consider drug-induced leg ulcers in patients treated with sunitinib, especially those with pre-existing vascular conditions.
  • Further research is warranted to elucidate the precise mechanisms by which sunitinib affects vascular integrity and ulcer formation.

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