Two cases of eczematous eruptions caused by everolimus

Abstract

Objective Everolimus, an inhibitor of the mammalian target of rapamycin, has been used in the treatment of several types of tumor. Erythematous maculopapular and acneiform rashes are the major dermatological adverse events associated with everolimus therapy, but we encountered two cases of eczematous eruption caused by everolimus. Method We assessed the clinical features and laboratory findings of the two cases. Results A 52‐year‐old woman and a 59‐year‐old man developed pruritic papules and erythema over their entire bodies after initiation of everolimus therapy. Both patients exhibited peripheral eosinophilia and increased serum thymus and activation‐regulated chemokine (TARC) levels. A skin biopsy from one patient revealed the features of chronic dermatitis. Both the skin manifestations and the pruritis disappeared rapidly after the discontinuation of everolimus treatment. The peripheral blood eosinophil and serum TARC levels also decreased. Conclusion Eczematous eruption associated with an elevated serum TARC level is a dermatological event associated with everolimus therapy.

Correlation between serum thymus and activation‐regulated chemokine levels and eczematous drug eruption following oral challenge test with clonazepam

“…A recent study showed that serum TARC levels were correlated with blood eosinophil counts in Type 2‐mediated drug eruptions 4 . In addition, elevated serum TARC levels have been reported in association with eczematous drug eruptions secondary to everolimus 5 . Our case showed elevation of serum TARC levels after the oral challenge test with clonazepam.…”

“…4 In addition, elevated serum TARC levels have been reported in association with eczematous drug eruptions secondary to everolimus. 5 Our case showed elevation of serum TARC levels after the oral challenge test with clonazepam. We also observed fluctuation of serum TARC levels in association with the clinical course of the eruption.…”

“…Education in self-management (which in pigmentary disorders includes the importance of sun-protective measures, including expert advice on sunscreen use) remains a cornerstone in management. As the usefulness of 'aesthetic procedures' for pigmentation remains poorly defined, a more instructive categorization could have sought dermatologists' knowledge of specific interventions, including the role of sunscreens blocking visible light, the synergistic role of antioxidants in photoprotection, 5 and the use of superficial chemical peels and laser devices in the management of pigmentary disorders. body.…”