Atypical skin reaction in a patient treated with gefitinib for advanced lung cancer: A case report and review of the literature

Abstract

Gefitinib is a selective epidermal growth factor receptor tyrosine kinase inhibitor utilized for the treatment of advanced non-small cell lung carcinoma. The most commonly reported adverse event during gefitinib therapy is skin rash, particularly a papulopustular acne-like eruption. Cutaneous toxicities can affect treatment compliance and the quality of life of the patient. The present study reports a case of gefitinib-induced atypical skin reaction in a 73-year-old woman with advanced non-small cell lung cancer, who developed a squamous-crusted eruption on her face after 4 weeks of oral treatment with gefitinib at a dose of 250 mg/day. The patient was treated with 100 mg minocyclin (2 tablets/day, orally) and with ryfamicin topically. A complete resolution of the lesions was observed 2 weeks later. The present case report explored the pathogenesis of this skin manifestation, focusing on the underlying immunological mechanisms. A review of the literature concerning skin reactions to gefitinib was also conducted.

Keywords: epidermal growth factor receptor; gefitinib; skin immune system.

Figure 1.

(A) Squamous-crusted eruption on the face of a 73-year old woman, who was undergoing oral treatment with gefitinib at an dose of 250 mg once daily. (B) A yellowish exophytic squamous-crusted lesion with sharp edges and an erythematous base on the forehead of the patient.

Figure 2.

Almost complete resolution of the lesions on the face of the patient after 2 weeks of oral treatment with 100 mg minocyclin (2 tablets/day) and topical treatment with rifamycin.