Toxic epidermal necrolysis caused by cetuximab plus minocycline in head and neck cancer.
We present a unique case of toxic epidermal necrolysis (TEN) caused by cetuximab plus minocycline during chemoradiation for recurrent squamous cell carcinoma of the head and neck (SCCHN). In April 2008, a 49-year-old man was diagnosed with recurrent SCCHN. He received surgery and postoperative adjuvant therapy with cetuximab plus chemoradiation. Because of exacerbation of acneform rash by cetuximab, minocycline was added thereafter. However, TEN appeared after the fifth course of weekly cetuximab, and cetuximab plus minocycline was assumed to be the cause. Cetuximab plus minocycline carries a risk of evoking TEN, and the side effects of chemoradiation for SCCHN mask some early signs of TEN. Noticing the transformation of skin lesions makes early diagnosis possible, and prompt cessation of the causative agent is essential for patients with TEN. We review the literature on cetuximab, minocycline, and TEN and discuss the impact of TEN on cancer therapy.
Lee
Shan-Shien
SS
Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chu
Pen-Yuan
PY
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology; D000068818:Cetuximab; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004815:Epidermal Growth Factor; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects* / Q000627:therapeutic use; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis / Q000209:etiology*
D000900:Anti-Bacterial Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D004815:Epidermal Growth Factor; D008911:Minocycline; D000068818:Cetuximab