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Cutaneous Adverse Effects of Hormonal and HER2-Targeted Therapies in Breast Cancer Patients: A Case Series

Lenique Kl Huggins, Jaya Manjunath, May Alorainy

    Journal of Drugs in Dermatology : JDD
    |July 6, 2026
    PubMed
    Abstract

    Insights

    Dermatologic adverse events (dAEs) from breast cancer therapies like aromatase inhibitors (AIs) and anti-HER2 agents are common. Prompt recognition and management of these skin toxicities are crucial for treatment adherence and quality of life.

    Area of Science:

    • Oncology
    • Dermatology
    • Pharmacology

    Background:

    • Aromatase inhibitors (AIs) and anti-HER2 therapies are vital for breast cancer survival.
    • Dermatologic adverse events (dAEs) associated with these treatments are often underrecognized.
    • dAEs can significantly impact patient quality of life and treatment adherence.

    Purpose of the Study:

    • To report cases of cutaneous toxicity associated with AIs and HER2-targeted agents.
    • To detail the clinical presentation, management strategies, and outcomes of these dAEs.
    • To highlight the importance of recognizing and managing skin toxicities in cancer patients.

    Main Methods:

    • Case series reporting four patients with cutaneous toxicity.
    • Detailed documentation of clinical presentation, treatment interventions, and patient outcomes.
    • Analysis of adverse events related to letrozole, anastrozole, trastuzumab, and pertuzumab.

    Main Results:

    • Three patients experienced acneiform eruptions: one on letrozole (resolved upon discontinuation) and two on trastuzumab/pertuzumab (requiring isotretinoin).
    • One patient developed lichen planus pigmentosus while on anastrozole, with limited response to treatment and subsequent cessation due to psychosocial distress.
    • Acneiform eruptions were observed with both HER2 blockade and AIs, while pigmentary disorders may be a novel AI-related toxicity.

    Conclusions:

    • Acneiform eruptions are a potential side effect of both HER2-targeted therapies and AIs.
    • Pigmentary disorders could represent a previously unrecognized toxicity of AIs.
    • Timely identification and targeted dermatologic care are essential to support continued cancer treatment and improve patient outcomes.

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