Allergy Asthma Immunol Res.  2015 May;7(3):304-307. 10.4168/aair.2015.7.3.304.

Sorafenib Induces Delayed-Onset Cutaneous Hypersensitivity: A Case Series

• Sohn KH
• Oh SY
• Lim KW
• Kim MY
• Lee SY
• Kang HR

• KMID: 2260470
• DOI: http://doi.org/10.4168/aair.2015.7.3.304

Abstract

Sorafenib is an oral multikinase inhibitor with clinical activity against hepatocellular carcinoma (HCC) and renal cell carcinoma. Administration of sorafenib carries a variety of adverse cutaneous reactions. Common adverse effects induced by sorafenib include hand-foot skin reactions, facial erythema, splinter subungual hemorrhage, and alopecia. Although erythema multiforme (EM) related to sorafenib has been reported, delayed-type cutaneous hypersensitivity reactions are rare in patients treated with sorafenib and there has been no case of Stevens-Johnson syndrome (SJS) reported so far. We recently experienced 3 cases of delayed-type cutaneous hypersensitivity related to administration of sorafenib. The first case was a 47-year female had targetoid erythematous rashes on her arms 12 days after starting sorafenib for HCC. The rashes spread from the arms to the trunk rapidly except for the hands and feet, and erosive lesions developed in the oral mucosa and lips. She was diagnosed as SJS. The second case was an 81-year-old male had maculopapular eruptions with multiple targetoid lesions on the trunk, arms, and legs 10 days after starting sorafenib for his HCC. There was no evidence of mucosal involvement. He was diagnosed with EM. The last one was a 20-year-old female developed generalized maculopapular eruptions in the whole body 10 days after starting sorafenib for the treatment of HCC. All 3 patients completely recovered after discontinuation of sorafenib.

Keyword

Sorafenib; erythema multiforme; Stevens-Johnson syndrome; hypersensitivity, delayed

MeSH Terms

Aged, 80 and over
Alopecia
Arm
Carcinoma, Hepatocellular
Carcinoma, Renal Cell
Erythema
Erythema Multiforme
Exanthema
Female
Foot
Hand
Hemorrhage
Humans
Hypersensitivity*
Hypersensitivity, Delayed
Leg
Lip
Male
Mouth Mucosa
Skin
Stevens-Johnson Syndrome
Young Adult

Figure

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  Figure Skin lesions observed in case 1 (A and B) and 2 (C and D).

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