Enfortumab vedotin‐induced cutaneous adverse events manifesting as miliaria‐like eruptions with the presence of keratinocyte apoptosis in clinically intact skin

Oya, Kazumasa; Nakamura, Yoshiyuki; Iwamoto, Kazuyo; Kimura, Tomokazu; Negoro, Hiromitsu; Nishiyama, Hiroyuki; Fujisawa, Yasuhiro

doi:10.1111/jdv.18406

Cited by 7 publications

(5 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 In addition, there are reports of prominent hyperpigmentation, superficial desquamation, vesicular eruptions, pruritus, dry eyes, and miliaria-like eruptions. 3,6 The miliaria-like eruptions showed intraepidermal vesiculation with mild-to-moderate immune cell infiltration, as well as keratinocyte apoptosis, a feature not present with true miliaria. 6 More serious lifethreatening drug reactions have been reported, including Steven Johnson Syndrome (SJS) and TEN, 7 and severe bullous eruptions leading to multi-organ failure and death.…”

Section: Discussionmentioning

confidence: 99%

“…3,6 The miliaria-like eruptions showed intraepidermal vesiculation with mild-to-moderate immune cell infiltration, as well as keratinocyte apoptosis, a feature not present with true miliaria. 6 More serious lifethreatening drug reactions have been reported, including Steven Johnson Syndrome (SJS) and TEN, 7 and severe bullous eruptions leading to multi-organ failure and death. 8 Two mechanisms have been proposed to explain the cutaneous toxicity of EV.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Enfortumab Vedotin Drug Eruption: Cutaneous Adverse Events and Histopathologic Findings

Casale,

Roth,

Wanat

et al. 2024

The American Journal of Dermatopathology

View full text Add to dashboard Cite

Enfortumab is a monoclonal antibody directed against nectin-4 and, when combined with vedotin, is an antibody–drug conjugate approved for the treatment of locally advanced or metastatic urothelial cancers. A 75-year-old woman with stage IV papillary urothelial carcinoma of the bladder who completed cycle 2 of enfortumab vedotin (EV) infusions presented to our dermatology department for new-onset symmetric and painful dusky erythematous patches on the extremities and trunk without mucosal involvement. Two biopsies were obtained, which revealed an interface dermatitis with notable ring mitoses within the basal and suprabasal layers of the epidermis without epidermal necrosis. The patient was diagnosed with toxic erythema of chemotherapy and improved with application of triamcinolone 0.1% ointment twice daily without discontinuation of her EV infusions. Although a targeted therapy, EV commonly exhibits cutaneous side effects due to the expression of nectin-4 in the skin. Most cutaneous side effects are mild and can be managed symptomatically. However, severe drug-induced eruptions, such as toxic epidermal necrolysis, have been described. The histologic findings of EV associated skin eruptions can aid in correctly identifying the culprit drug and assist in management. This case provides insights for dermatologists by highlighting the common cutaneous side effects of EV and the associated histologic findings as this targeted therapy becomes increasingly utilized in the treatment of refractory neoplasms.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Enfortumab Vedotin Drug Eruption: Cutaneous Adverse Events and Histopathologic Findings

Casale,

Roth,

Wanat

et al. 2024

The American Journal of Dermatopathology

View full text Add to dashboard Cite

show abstract

“…We believe that the difference should be mainly attributed to the development and clinical application of novel anti-tumor drugs and widespread attention to their skin toxicity in recent years ( Quach et al, 2021 ; Nikolaou et al, 2022 ). In real-world scenarios, pharmacovigilance can be a handy tool for detecting and validating the potential skin toxicity of drugs, and several studies using the pharmacovigilance method have reported a risk of SCARs caused by some targeted antineoplastic drugs ( Yang et al, 2021 ; Zhu et al, 2021 ), and some of the results were verified in clinical practice ( Birmingham et al, 2022 ; Oya et al, 2022 ). Our results are consistent with their data mining findings, which illustrates the reliability of our results, more importantly; however, we captured that the main causative drugs of SCARs have changed in recent years, and antineoplastics have become an important drug class leading to SCARs.…”

Section: Discussionmentioning

confidence: 99%

Severe cutaneous adverse reactions to drugs: A real-world pharmacovigilance study using the FDA Adverse Event Reporting System database

Gou

Zhu

et al. 2023

Front. Pharmacol.

View full text Add to dashboard Cite

Background: Sound drug safety information is important to optimize patient management, but the widely recognized comprehensive landscape of culprit-drugs that cause severe cutaneous adverse reactions (SCARs) is currently lacking.Objective: The main aim of the study is to provide a comprehensive landscape of culprit-drugs for SCARs to guide clinical practice.Methods: We analyzed reports associated with SCARs in the FDA Adverse Event Reporting System database between 1 January 2004 and 31 December 2021 and compiled a list of drugs with potentially serious skin toxicity. According to this list, we summarized the reporting proportions of different drugs and drug classes and conducted disproportionality analysis for all the drugs. In addition, the risk characteristic of SCARs due to different drugs and drug classes was summarized by the positive–negative distribution based on the results of the disproportionality analysis.Results: A total of 77,789 reports in the FDA Adverse Event Reporting System database were considered SCAR-related, of which lamotrigine (6.2%) was the most reported single drug followed by acetaminophen (5.8%) and allopurinol (5.8%) and antibacterials (20.6%) was the most reported drug class followed by antiepileptics (16.7%) and antineoplastics (11.3%). A total of 1,219 drugs were reported as culprit-drugs causing SCARs in those reports, and the largest number of drugs belonged to antineoplastics. In disproportionality analysis, 776 drugs showed at least one positive pharmacovigilance signal. Drugs with the most positive signals were lamotrigine, acetaminophen, furosemide, and sulfamethoxazole/trimethoprim.Conclusion: Our study provided a real-world overview of SCARs to drugs, and the investigation of SCAR positive–negative distribution across different drugs revealed its risk characteristics, which may help optimize patient management.

show abstract

“…This case showed dyskeratosis mainly observed in the suprabasal area and similar cases have been reported. 2,3 In addition, suprabasal dyskeratosis in clinically intact skin have also been reported in a case with EV-related rash displaying milia-like eruptions. 2 Recently, Penny et al 4 reported two cases of EV-related rash demonstrating keratinocyte cell surface deposition of IgG and C3 concentrated in the upper half of the epidermis.…”

Section: Cutaneous Toxicity With Suprabasal Blisters and Dyskeratosis...mentioning

confidence: 91%

“…2,3 In addition, suprabasal dyskeratosis in clinically intact skin have also been reported in a case with EV-related rash displaying milia-like eruptions. 2 Recently, Penny et al 4 reported two cases of EV-related rash demonstrating keratinocyte cell surface deposition of IgG and C3 concentrated in the upper half of the epidermis. Although it was not concluded that the detected antibodies were EV, these results are interesting because nectin-4 is expressed in the suprabasal layers of the normal epidermis.…”

Section: Cutaneous Toxicity With Suprabasal Blisters and Dyskeratosis...mentioning

confidence: 91%

Cutaneous toxicity with suprabasal blisters and dyskeratosis following administration of enfortumab vedotin

Hasui

Kawakami

Miyake

et al. 2022

The Journal of Dermatology

View full text Add to dashboard Cite

Enfortumab vedotin‐induced cutaneous adverse events manifesting as miliaria‐like eruptions with the presence of keratinocyte apoptosis in clinically intact skin

Cited by 7 publications

References 7 publications

Enfortumab Vedotin Drug Eruption: Cutaneous Adverse Events and Histopathologic Findings

Enfortumab Vedotin Drug Eruption: Cutaneous Adverse Events and Histopathologic Findings

Severe cutaneous adverse reactions to drugs: A real-world pharmacovigilance study using the FDA Adverse Event Reporting System database

Cutaneous toxicity with suprabasal blisters and dyskeratosis following administration of enfortumab vedotin

Contact Info

Product

Resources

About