Gefitinib-induced Toxic Epidermal Necrolysis in a Patient with Metastatic Non–small cell Lung Cancer
L Yang, KO Lam, VHF Lee, AWM Lee
Hong Kong J Radiol 2018;21:e8-11
DOI: 10.12809/hkjr1816416
Toxic epidermal necrolysis (TEN) is a rare acute life-threatening mucocutaneous condition that is usually caused by a reaction to drugs (80-95%). It is characterised by widespread sloughing of the skin and mucosa. Gefitinib, a small-molecule epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, is a standard first-line treatment for EGFR-mutated metastatic non–small cell lung cancer. We report a case of TEN complicating gefitinib treatment in a 65-year-old woman with metastatic pulmonary adenocarcinoma. She developed skin eruptions on day 5 of treatment that rapidly evolved to TEN on day 8. This case report highlights the rapidly evolving course of gefitinib-induced TEN and the importance of early diagnosis, prompt withdrawal of the drug, and intensive care.
Author affiliation(s):
L Yang, KO Lam, VHF Lee, AWM Lee: Clinical Oncology Center, University of Hong Kong–Shenzhen Hospital, Shenzhen, China
中文摘要
在一名轉移性非小細胞肺癌患者中吉非替尼誘發中毒性表皮壞死鬆解
楊利、林嘉安、李浩勳、李詠梅
中毒性表皮壞死鬆解（TEN）是罕見的急性危及生命的皮膚病並通常由藥物反應引致（80-95%）。它的特點是皮膚和粘膜廣泛脫落。吉非替尼是一種小分子表皮生長因子受體（EGFR）酪氨酸激酶抑製劑，是EGFR突變轉移性非小細胞肺癌的標準一線治療。我們報告一例65歲轉移性肺腺癌女性患者因吉非替尼治療誘發TEN。她在治療開始後第5天皮膚出疹，第8天迅速發展為TEN。本病例報告突出了吉非替尼誘發TEN的快速發展過程以及早期診斷、及時中止藥物和重症監護的重要性。