Acneiform Rash Induced by EGFR Inhibitors: Review of the Literature and New Insights

Fabbrocini, Gabriella; Panariello, Luigia; Caro, Gemma; Cacciapuoti, Sara

doi:10.1159/000371821

Cited by 66 publications

(52 citation statements)

References 21 publications

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“…Histopathological examination of specimens of papulopustular lesions demonstrated some minor inflammatory infiltrations around dilated orifices of hair follicles filled with corneous masses. Disruption of hair follicles was also observed, with an acute, mostly neutrophilic inflammation around, that in time could transform into chronic granulomatous form, close to histopathological presentation of papulopustular eruptions observed in acne [12,13]. Inflammatory infiltrations consisted mostly of neutrophils or components of chronic granulomatous infiltrations: lymphocytes, histiocytes and giant cells [14].…”

Section: Discussionmentioning

confidence: 55%

“…W badaniu histopatologicznym wycinków pobranych ze zmian grudkowo-krostkowych obserwowano niewielkie powierzchowne nacieki zapalne dookoła poszerzonych i wypełnionych masami rogowymi ujść mieszków włosowych. Dochodziło także do przerwania mieszka włosowego z ostrym, głównie neutrofilowym zapaleniem dookoła, które mogło z czasem przybierać formę przewlekłą ziarniniakową, co jest bliskie obrazowi histopatologicznemu zapalnych wykwitów grudkowo-krostkowych w trądziku [12,13]. W składzie nacieków zapalnych stwierdzono przede wszystkim neutrofile lub składowe przewlekłych nacieków ziarniniakowych: limfocyty, histiocyty i komórki olbrzymie [14].…”

Section: Discussionunclassified

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Dermatological adverse effects in a cancer patient treated with an EGFR inhibitor. Case report and literature review

Korzycka¹,

Osmola‐Mańkowska²,

Bowszyc‐Dmochowska³

et al. 2018

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Introduction. Epidermal growth factor receptor inhibitors (EGFR inhibitors) are used for treatment of advanced malignant tumours associated with EGFR overexpression. In over 50% of treated patients dermatological adverse effects are observed, occurring in form of the PRIDE syndrome (papulopustules and/or paronychia, regulatory abnormalities of hair growth, itching and dryness due to epidermal growth factor receptor inhibitors). Objective. The presented case ilustrates cutaneous adverse events of EGFR inhibitors, an increasing problem in modern medicine. Case report. A 51-year old man treated with panitumumab for advanced stage of rectal cancer was admitted to the hospital because of a papulopustular rash. A specimen of skin was collected for histopathological analysis and revealed an acne-like rash, typical for EGFR inhibitors. Conclusions. EGFR inhibitors are a common cause of cutaneous adverse events. Early identification and tretment of these lesions may decrease the risk of adverse-dependent change in oncological threapy. streszCzenie Wprowadzenie. Inhibitory receptora naskórkowego czynnika wzrostu (EGFR) stosowane są w leczeniu zaawansowanych nowotworów złośliwych, w których stwierdza się nadekspresję EGFR. W trakcie terapii u ponad 50% pacjentów obserwuje się skórne objawy niepożądane występujące w postaci zespołu PRIDE (papulopustules and/or paronychia, regulatory abnormalities of hair growth, itching and dryness due to epidermal growth factor receptor inhibitors). Cel pracy. Przypadek przedstawiono ze względu na coraz częstsze stosowanie inhibitorów EGFR we współczesnej medycynie. Case report/Opis przypadku dermatological adverse effects in a cancer patient treated with an egFr inhibitor. Case report and literature review skórne objawy niepożądane u pacjenta onkologicznego leczonego inhibitorem egFr. opis przypadku i przegląd piśmiennictwa Magdalena korzycka 1 , agnieszka j. osmola-Mańkowska 2 , Monika bowszyc-dmochowska 3 , ryszard W. Żaba 4 , zygmunt adamski 2

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Section: Discussionmentioning

confidence: 55%

Section: Discussionunclassified

Dermatological adverse effects in a cancer patient treated with an EGFR inhibitor. Case report and literature review

Korzycka¹,

Osmola‐Mańkowska²,

Bowszyc‐Dmochowska³

et al. 2018

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“…and EGFR tyrosine kinase inhibitors (erlotinib, gefitinib, osimertinib, etc.) can also cause a similar form of rash [8]. Histopathology typically shows superficial inflammatory cell infiltrate surrounding upper portion hair follicles or superficial neutrophilic suppurative folliculitis with rupture of epithelia lining.…”

Section: Discussionmentioning

confidence: 99%

Ibrutinib-Induced Vasculitis in a Patient with Metastatic Colon Cancer Treated in Combination with Cetuximab

Chi

Park

Saif

2020

Case Reports in Oncological Medicine

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Combination therapy with ibrutinib and cetuximab is being studied in a phase 1b/2 trial in patients with advanced gastrointestinal and genitourinary malignancies. Rash is a common cutaneous adverse effect for both medications. Ibrutinib is a Bruton’s tyrosine kinase (BTK) inhibitor approved for the treatment of several hematologic malignancies. The rash can be asymptomatic, nonpalpable, mild skin eruption, or palpable purpuric rash. A rarer panniculitis form has also been reported. Cetuximab, an epidermal growth factor (EGFR) inhibitor, approved for treatment in head and neck and advanced gastrointestinal malignancies is also known to cause acneiform rash in majority of patients. The rash is due to inhibition of EGFR in the basal keratinocytes and hair follicles. In the case of ibrutinib, the off-target effects on EGFR, c-kit, and platelet-derived growth factor receptor (PDGFR) are thought to be responsible for the cutaneous eruption of various forms of rash. The combination therapy with the BTK inhibitor and a direct EGFR inhibitor may potentiate the rash inducing effects of the drugs. Here, we describe a case of vasculitis in a patient with metastatic colon cancer who received both ibrutinib and cetuximab on a phase Ib/II clinical trial.

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“…Secondarily, there is increased synthesis of inflammatory chemokines leading to inflammation. The inflammatory cell infiltration leads to the cutaneous manifestations 5…”

Section: Discussionmentioning

confidence: 99%

Cetuximab associated dermal filler reaction

Pathmanathan¹,

Dzienis

2019

BMJ Case Rep

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A 52-year-old male patient with hyaluronic acid-based dermal fillers injected in his cheeks was diagnosed with glossotonsillary malignancy, and managed with concurrent cetuximab (epidermal growth factor receptor inhibitor) and radiation therapy. He developed significant inflammation around the dermal filler sites after first cycle of cetuximab which improved with dissolution of the dermal fillers with hyaluronidase. This suggests that cetuximab can lead to inflammation around the dermal filler sites, which can be treated with dissolution of the filler.

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Acneiform Rash Induced by EGFR Inhibitors: Review of the Literature and New Insights

Cited by 66 publications

References 21 publications

Dermatological adverse effects in a cancer patient treated with an EGFR inhibitor. Case report and literature review

Dermatological adverse effects in a cancer patient treated with an EGFR inhibitor. Case report and literature review

Ibrutinib-Induced Vasculitis in a Patient with Metastatic Colon Cancer Treated in Combination with Cetuximab

Cetuximab associated dermal filler reaction

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