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Published on: June 17, 2025

Selpercatinib-Induced Deep Skin Fissures Triggered by Mechanical Friction in a Patient With RET Fusion-Positive Lung

Tomoyuki Ikeuchi1, Mitsuhiro Yamamoto1, Hirokazu Toge1

  • 1Department of Respiratory Medicine National Hospital Organization (NHO) Yonago Medical Center Yonago Japan.

Respirology Case Reports
|July 17, 2026
PubMed

Insights

Selpercatinib can cause severe fingertip fissures in patients with RET fusion-positive lung adenocarcinoma. Stopping the drug and using corticosteroids improved the skin condition, allowing treatment to continue.

Area of Science:

  • Oncology
  • Dermatology
  • Pharmacology

Background:

  • Selpercatinib is a targeted therapy for RET fusion-positive lung adenocarcinoma.
  • VEGF receptor inhibition is a known mechanism of action for selpercatinib.
  • Skin toxicities are potential side effects of targeted cancer therapies.

Purpose of the Study:

  • To report a case of deep skin fissures induced by selpercatinib.
  • To explore the potential mechanism of selpercatinib-induced skin fissures.
  • To describe the management and outcome of this adverse event.

Main Methods:

  • Case report of a patient with RET fusion-positive lung adenocarcinoma.
  • Observation of selpercatinib-induced fingertip fissures.
  • Assessment of treatment response to drug withdrawal and corticosteroid administration.

Main Results:

  • A patient developed severe fingertip fissures after starting selpercatinib.
  • Fissures were triggered by minor abrasions and potentially worsened by VEGF receptor inhibition.
  • Discontinuation of selpercatinib and administration of corticosteroids led to improvement.

Conclusions:

  • Selpercatinib can cause significant skin toxicity, specifically deep fissures.
  • VEGF receptor inhibition may play a role in the pathogenesis of these fissures.
  • Management involves drug withdrawal, corticosteroids, and careful monitoring for recurrence.
Keywords:
deep skin fissureslung adenocarcinomarearranged during transfection (RET) fusionselpercatinibvascular endothelial growth factor receptor (VEGFR)

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