Adverse Cutaneous Reactions to Erlotinib

Pitarch, G.; Garde, J.; Torrijos, A.; Juárez, A.; Febrer, M.I.; Camps, C.

doi:10.1016/S1578-2190(08)70194-X

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Abstract

Introduction

Erlotinib is an inhibitor of human epidermal growth factor approved for treating nonsmall cell lung cancer. The aim of this prospective observational study was to determine the prevalence of adverse cutaneous reactions caused by erlotinib and assess the management of such effects.

Methods

Eleven patients with lung cancer and 1 with ovarian cancer received erlotinib at a dose of 150mg/d. The prevalence, severity, and time course of the adverse cutaneous reactions were assessed.

Results

The most frequent cutaneous reaction was acneiform eruption (10 cases). The patients were treated with topical erythromycin and clindamycin, or with doxycycline. Also reported were seborrheic dermatitis (5), paronychia (4), xerosis (3), mouth blisters (3), blepharitis (2), cheilitis (1), and fissures on the hands and feet (1). The first reactions to appear were seborrheic dermatitis (9.8 days until onset) and acneiform eruption (11.8 days), whereas the paronychia presented latest (65.3 days). One patient with acneiform eruption and another with paronychia suspended treatment until the lesions improved.

Conclusions

Erlotinib induces adverse effects in most patients treated. Acneiform eruption, seborrheic dermatitis, and paronychia are the most frequently reported reactions and can lead to temporary suspension of erlotinib administration.

Key words:

erlotinib

epidermal growth factor receptor

acneiform

seborrheic dermatitis

paronychia

Resumen

Introducción

El erlotinib es un inhibidor del factor de crecimiento epidérmico humano aprobado en el tratamiento del cáncer de pulmón no microcítico. El objetivo de este estudio prospectivo y observacional es determinar la prevalencia de los efectos cutáneos adversos por erlotinib y su manejo.

Métodos

Once pacientes con cáncer de pulmón y una con cáncer de ovario fueron tratados con erlotinib en dosis de 150 mg diarios. Se evaluó la prevalencia, la intensidad y la cronología de los efectos cutáneos adversos.

Resultados

La reacción cutánea más frecuente fue la erupción acneiforme (10 casos). Los pacientes fueron tratados con eritromicina o clindamicina tópicas, o con doxicilina. Los pacientes también desarrollaron dermatitis seborreica (5), paroniquia (4), xerosis (3), aftas orales (3), blefaritis (2), queilitis (1) y fisuras en manos y pies (1). Los efectos adversos más precoces fueron la dermatitis seborreica (9,8 días hasta la aparición) y la erupción acneiforme (11,8 días), mientras que la paroniquia fue el efecto más tardío (65,3 días). Un paciente con erupción acneiforme y otro con paroniquia suspendieron el tratamiento con erlotinib hasta la mejoría de las lesiones.

Conclusiones

El erlotinib produce efectos cutáneos adversos en la gran mayoría de los pacientes tratados. La erupción acneiforme, la dermatitis seborreica y la paroniquia son los efectos más frecuentes, que pueden llevar a interrumpir temporalmente la administración de erlotinib.

Palabras clave:

erlotinib

receptor de factor de crecimiento epidérmico

acneiforme

dermatitis seborreica

paroniquia

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