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Osimertinib-Induced Toxic Epidermal Necrolysis - A Case Report
Simonida Crvenkova1, Maja Popova1, Labina Crvenkova2
11Faculty of Medicine, University Clinic of Radiotherapy and Oncology, Skopje, Macedonia.
Summary
Osimertinib, used for lung cancer, can rarely cause toxic epidermal necrolysis (TEN), a severe skin reaction. Prompt treatment with steroids and immunoglobulin led to a patient's recovery, highlighting the need for vigilance.
Area of Science:
- Oncology
- Dermatology
- Pharmacology
Background:
- Osimertinib is a third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) used for EGFR-mutated lung adenocarcinoma.
- While skin toxicity is a known side effect of EGFR-TKIs, severe reactions like toxic epidermal necrolysis (TEN) are rare with Osimertinib.
Observation:
- A 44-year-old woman with lung adenocarcinoma developed a diffuse erythematous rash, vesicles, purpuric macules, facial and truncal erythema/exfoliation, and severe mucositis 10 days after initiating Osimertinib.
- The patient's symptoms were consistent with toxic epidermal necrolysis (TEN), a life-threatening delayed-type drug hypersensitivity reaction.
Findings:
- The patient received systemic steroids, immunoglobulin, and supportive care.
- This treatment regimen resulted in improved general wellbeing and a remarkable recovery from TEN.
Implications:
- This case underscores the rare but severe potential side effects of Osimertinib, emphasizing the need for increased clinical awareness.
- Healthcare providers should be vigilant for adverse reactions and prepared for timely management of Osimertinib-induced toxic epidermal necrolysis.
