Severe Purpuric Xerotic Dermatitis Associated With Gefitinib Therapy

Purpuric drug eruptions induced by EGFR tyrosine kinase inhibitors are associated with IQGAP1‐mediated increase in vascular permeability

“…In the presence of erlotinib, IQGAP1 may be increased in a compensatory manner to rescue the EGFR pathway in the endothelial cells . Consequently, the overexpression of IQGAP1 leads to the disruption of adherens junctions and results in the extravasation of erythrocytes . IQGAP1 may be an attractive therapeutic target for treatment of purpuric drug eruptions.…”

“…However, these drugs may cause a range of cutaneous reactions, such as acneiform rash, pruritus, paronychia, and xeroderma . In addition to common papulopustular reactions, there have also been several reports of EGFR‐TKIs being associated with vascular adverse events, namely, purpuric drug eruptions , leukocytoclastic vasculitis , livedo reticularis with retiform purpura , and purpura with petechiae . These conditions might belong to a spectrum of a single disorder.…”

Subcorneal Pustular Dermatosis: A Review of 30 Years of Progress

“…They presented with unusual distributions and varying histologic findings in regard to the presence or absence of spongiosis and acantholysis. These cases involved isoniazid [44], gefitinib [45], paclitaxel [46], cefazolin [47], and amoxicillin [48]. A case of subcorneal pustules induced by dapsone and quinidine in a patient with known SPD has also been reported [49].…”

Purpuric drug eruption with leukocytoclastic vasculitis due to gefitinib

“…Our review of the published work uncovered only four previously-reported patients, two of which developed LCV. [3][4][5] The purpuric eruptions in both patients without LCV improved without discontinuing gefitinib, while the other two patients' improvement required the cessation of gefitinib administration. In both of our patients with LCV, gefitinib treatment had to be temporarily halted to allow for the amelioration of their skin lesions.…”

“…Although acneiform drug eruption is a recognized cutaneous adverse reaction to gefitinib, purpuric drug eruptions are rare. Our review of the published work uncovered only four previously‐reported patients, two of which developed LCV 3–5 . The purpuric eruptions in both patients without LCV improved without discontinuing gefitinib, while the other two patients’ improvement required the cessation of gefitinib administration.…”