Hand, foot and scrotal blisters in a patient with cancer receiving oral chemotherapy.
Tyrosine kinase inhibitors are novel antineoplastic drugs that make use of the molecular abnormalities that have been discovered in certain types of tumours. These agents are associated with important dermatological side effects. This case report discusses an atypical presentation of the hand-foot syndrome in one patient treated with sorafenib. A 78-year-old man, recently started on sorafenib for the treatment of hepatocarcinoma with lung metastasis, presented to the emergency room with painful blistering lesions on the palms, soles and scrotum for 1 week. A punch biopsy was performed and sorafenib was withheld. Direct immunofluorescence study was negative for an autoimmune blistering disorder and histopathology stains did not show any microorganisms. A diagnosis of hand-foot syndrome was made. After 2 weeks, the patient showed marked improvement and the plan was to restart sorafenib at a lower dosage.
Department of Medicine, Metropolitan Hospital Center/New York Medical College, New York, New York, USA.
Jose Rodolfo
JR
Guerra
Department of Medicine, Metropolitan Hospital Center/New York Medical College, New York, New York, USA.
Ana M
AM
Suelves
Department of Medicine, Metropolitan Hospital Center/New York Medical College, New York, New York, USA.
Archie
A
Bella
Department of Medicine, Metropolitan Hospital Center/New York Medical College, New York, New York, USA.
Delatre
D
Lolo
D000284:Administration, Oral; D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000368:Aged; D001768:Blister / Q000139:chemically induced* / Q000503:physiopathology; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000556:secondary; D003875:Drug Eruptions / Q000209:etiology* / Q000503:physiopathology; D005533:Foot Dermatoses / Q000209:etiology* / Q000503:physiopathology; D006229:Hand Dermatoses / Q000139:chemically induced / Q000503:physiopathology; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012611:Scrotum; D012720:Severity of Illness Index; D000077157:Sorafenib; D013577:Syndrome; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D009536:Niacinamide; D000077157:Sorafenib