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Lapatinib-induced acute generalized exanthematous pustulosis
Chembolli Lakshmi1, Suma Pillai, C R Srinivas
1Department of Dermatology, PSG Hospitals and PSGIMSR, Coimbatore, Tamil Nadu, India.
Indian Dermatology Online Journal
|November 7, 2012
Summary
A rare skin reaction, acute generalized exanthematous pustulosis (AGEP), occurred in a patient treated with lapatinib, an EGFR inhibitor. This case highlights a potential drug-induced AGEP linked to lapatinib.
Area of Science:
- Dermatology
- Oncology
- Pharmacology
Background:
- Acute generalized exanthematous pustulosis (AGEP) is a severe drug-induced skin reaction.
- It typically presents with fever, leukocytosis, and a widespread pustular rash.
- Lapatinib is a tyrosine kinase inhibitor used to treat metastatic breast cancer.
Observation:
- A 56-year-old woman developed AGEP after starting lapatinib for metastatic disease.
- The patient presented with erythematous papules, plaques, peripheral pustules, and pyogenic granuloma-like lesions.
- Lesions resolved after discontinuation of lapatinib.
Findings:
- This case represents a potential first report of AGEP associated with lapatinib, an EGFR inhibitor.
- The clinical presentation and resolution suggest a causal link between lapatinib and AGEP.
- This contrasts with known AGEP associations with other kinase inhibitors like imatinib.
Implications:
- Clinicians should be aware of the potential for lapatinib to induce AGEP.
- Early recognition and withdrawal of lapatinib may be crucial for managing this adverse reaction.
- Further investigation into lapatinib-induced dermatologic reactions is warranted.
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