Yonsei Med J.  2008 Oct;49(5):851-852. 10.3349/ymj.2008.49.5.851.

Severe Acneiform Eruption Induced by Cetuximab (Erbitux(R))

• Lee JE
• Lee SJ
• Lee HJ
• Lee JH
• Lee KH

• KMID: 2158205
• DOI: http://doi.org/10.3349/ymj.2008.49.5.851

Abstract

Epidermal growth factor has an important role in the regulation of proliferation and differentiation in epidermal keratinocytes, as well as in the survival, angiogenesis and metastasis of cancer cells. Cetuximab is a chimeric monoclonal antibody selective for the epidermal growth factor receptor that induces a broad range of cellular responses that enhance tumor sensitivity to radiotherapy and chemotherapeutic agents. However, it can cause adverse events in the patient including acneiform eruption, asthenia, abdominal pain and nausea/vomiting. We report a case of severe acneiform eruption induced by cetuximab in a 56-year-old man with colorectal cancer and liver metastases.

Keyword

Cetuximab; acneiform eruption

MeSH Terms

Acneiform Eruptions/*chemically induced/pathology
Antibodies, Monoclonal/*adverse effects/therapeutic use
Antineoplastic Agents/*adverse effects
Colorectal Neoplasms/drug therapy/pathology
Humans
Liver Neoplasms/drug therapy/secondary
Male
Middle Aged

Figure

• 

  Fig. 1 Multiple pinhead to rice-sized erythematous pustules on the face and upper trunk.

• 

  Fig. 2 Neutrophilic iinfiltrate around adnexa in the dermis.

Reference

1. Reynolds NA, Wagstaff AJ. Cetuximab: in the treatment of metastatic colorectal cancer. Drugs. 2004. 64:109–118. discussion 119-21.

2. Segaert S, Van Cutsem E. Clinical signs, pathophysiology and management of skin toxicity during therapy with epidermal growth factor receptor inhibitors. Ann Oncol. 2005. 16:1425–1433.

3. Jacot W, Bessis D, Jorda E, Ychou M, Fabbro M, Pujol JL, et al. Acneiform eruption induced by epidermal growth factor receptor inhibitors in patients with solid tumours. Br J Dermatol. 2004. 151:238–241.

4. Kimyai-Asadi A, Jih MH. Follicular toxic effects of chimeric anti-epidermal growth factor receptor antibody cetuximab used to treat human solid tumors. Arch Dermatol. 2002. 138:129–131.

5. Monti M, Mancini LL, Ferrari B, Rahal D, Santoro A. Complications of therapy and a diagnostic dilemma case. Case 2. Cutaneous toxicity induced by cetuximab. J Clin Oncol. 2003. 21:4651–4653.

6. Segaert S, Tabernero J, Chosidow O, Dirschka T, Elsner J, Mancini L, et al. The management of skin reactions in cancer patients receiving epidermal growth factor receptor targeted therapies. J Dtsch Dermatol Ges. 2005. 3:599–606.

7. Molinari E, De Quatrebarbes J, André T, Aractingi S. Cetuximab-induced acne. Dermatology. 2005. 211:330–333.