Bevacizumab-induced pityriasis rubra pilaris-like eruption

Area of Science:

• Dermatology
• Ophthalmology

Background:

• Pityriasis rubra pilaris (PRP) is a rare, chronic inflammatory skin disorder.
• Etiologies are poorly understood, with vitamin A deficiency and autoimmune factors hypothesized.
• Medication-induced PRP-like eruptions are exceptionally rare.

Observation:

• A 70-year-old male presented with erythroderma.
• The condition was clinically and histologically consistent with pityriasis rubra pilaris.
• Onset occurred 10 days post-intravitreal bevacizumab injection for age-related macular degeneration.

Findings:

• This is the first reported case of pityriasis rubra pilaris associated with bevacizumab.
• Bevacizumab, an anti-VEGF agent, may trigger PRP-like skin reactions.
• The patient's presentation mimicked classic PRP.

Implications:

• Highlights the importance of recognizing rare adverse drug reactions.
• Clinicians should consider bevacizumab as a potential cause of PRP-like eruptions.
• Further investigation into immune-modulating effects of anti-VEGF therapies is warranted.