Unusually Severe Bullous Skin Reaction to Sorafenib: A Case Report

Benjamin Hagopian, Clifford D Packer

Abstract


       While there are multiple reports on sorafenib-induced hand foot skin reaction, this case report details a patient presenting with an unusually severe and painful skin reaction. As the armamentarium of anti-neoplastic kinase inhibitors continues to increase, clinicians must be aware of the array of skin reactions these drugs can induce. A 66 years old Caucasian male with metastatic renal cell carcinoma presented with flu-like symptoms, rash, and painful bullous lesions of his fingertips. After empiric coverage with antibiotics and an infectious workup that turned up negative, it was determined that the patient’s presentation was due to a severe and painful hand skin reaction to sorafenib. While most patients taking sorafenib will experience a cutaneous side effect, the hand foot skin reaction can be extremely debilitating and occurs frequently. Oncologists and dermatologists must be informed about the array of adverse effects of kinase inhibitors, as treatment adherence and outcomes are at stake. In this case report, the bullous skin reaction, debilitating hand pain, and absence of foot involvement were the interesting features.




doi:10.4021/jmc112e

Keywords


Sorafenib; Hand foot skin reaction

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