Reactions 1497, p38 - 19 Apr 2014

Vandetanib

Photo-induced erythema multiforme in an elderlypatient: case report

A 66-year-old man developed photo-induced erythemamultiforme following treatment with vandetanib for metastaticmedullary thyroid carcinoma.

The man presented with a 7-day history of pruritic rash,which started on his face and spread posteriorly to otherphoto-exposed regions. Examination found well delineatederythematous plaques and papules with an eczematousappearance on his neck, ears, face and dorsal aspects of thehands; target lesions were also noted on the palms. His skinlesions developed 6 weeks after initiating vandetanib300 mg/day for metastatic medullary thyroid carcinoma [routenot stated]. Superficial and interstitial perivascular dermatitiswith eosinophils, mild spongiosis, degenerated keratinocytesand vacuolar-type interface dermatitis were observedfollowing hand and neck skin biopsy. His minimal erythemadose for UVA was <1 J/cm2. These results led to a diagnosis ofphoto-induced erythema multiforme.

Sun protection and fluticasone propionate were initiated.The man’s skin lesion resolved 2 weeks later.

Author comment: "Reported mucocutaneouscomplications included acneiform eruption and dry skin, butphotosensitivity is the most characteristic reaction. . . It couldmanifest as exaggerated sunburn, erythematous or lichenoideruption, and less frequently as photoinduced subacutecutaneous lupus erythematosus or photoinduced erythemamultiforme."Gutierrez DC, et al. Erythema multiforme photoinduced by vandetanib. Journal ofthe American Academy of Dermatology 70 (Suppl. 1): AB155 abstr. P8358, No. 5,May 2014 - Spain 803102012

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Reactions 19 Apr 2014 No. 14970114-9954/14/1497-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved