title: Afatinib-associated Stevens-Johnson syndrome in an EGFR-mutated lung cancer patient.
abstract: BACKGROUND
  Afatinib is a tyrosine kinase inhibitor (TKI), that has been approved for treating patients with epidermal growth factor receptor (EGFR) mutated advanced non-small-cell lung cancer (NSCLC). Stevens-Johnson syndrome (SJS) related to EGFR directed TKIs is a rare adverse event.
  
  
  METHODS
  We report a case of a 79-year-old white female with EGFR-mutated, metastatic non-small-cell lung cancer treated with afatinib as first-line palliative treatment, who developed a SJS after two months of treatment. Discontinuation of the TKI and systemic glucocorticoid treatment led to improvement of symptoms and recovery.
  
  
  CONCLUSIONS
  Severe adverse cutaneous drug reactions that predominantly involve the skin and mucous membranes during treatment with afatinib should alert clinicians to suspect SJS and react appropriately.
authors.affiliation: Department of Respiratory Medicine, Allergology and Sleep Medicine, Paracelsus Medical University, General Hospital Nuernberg, Nuremberg, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Doesch
authors.affiliation: Department of Dermatology, Paracelsus Medical University, General Hospital Nuernberg, Nuremberg, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Debus
authors.affiliation: Institute of Pathology, Paracelsus Medical University, General Hospital Nuernberg, Nuremberg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Meyer
authors.affiliation: Institute of Pathology, Paracelsus Medical University, General Hospital Nuernberg, Nuremberg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Papadopoulos
authors.affiliation: Department of Dermatology, Paracelsus Medical University, General Hospital Nuernberg, Nuremberg, Germany.
authors.forename: Erwin S
authors.initials: ES
authors.lastname: Schultz
authors.affiliation: Department of Respiratory Medicine, Allergology and Sleep Medicine, Paracelsus Medical University, General Hospital Nuernberg, Nuremberg, Germany.
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ficker
authors.affiliation: Department of Respiratory Medicine, Allergology and Sleep Medicine, Paracelsus Medical University, General Hospital Nuernberg, Nuremberg, Germany. Electronic address: Wolfgang.brueckl@klinikum-nuernberg.de.
authors.forename: Wolfgang M
authors.initials: WM
authors.lastname: Brueckl
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000077716:Afatinib; D000368:Aged; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics*; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D011799:Quinazolines / Q000009:adverse effects*; D012867:Skin / Q000473:pathology; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000077716:Afatinib; D066246:ErbB Receptors
keywords: Afatinib; NSCLC; SJS; TKI