RESEARCH LETTERSA New Spectrum of Skin Toxic Effects Associated With the Multikinase Inhibitor Vandetanib S kin manifestations are among the most frequent adverse effects of targeted therapies. 1 Hyperkeratosis and hand-foot skin reaction are observed with most raf and vascular endothelial growth factor (VEGF) inhibitors, whereas folliculitis is a hallmark of epidermal growth factor receptor (EGFR) blocking agents. 1 Vandetanib (Zactima, ZD6474; AstraZeneca) is a multikinase inhibitor that targets EGFR, VEGF receptors 1, 2, and 3 and the RET (rearranged during transfection) receptor. 2 Methods. Between November 2005 and October 2009, patients with metastatic thyroid cancer received vandetanib at a dose of 300 mg/d in 3 clinical trials: a phase 2 open-label study (NCT00098345) 3 and 2 randomized phase 3 studies comparing vandetanib with a placebo (NCT00537095 and NCT00410761). Clinical examination of all patients exhibiting any skin manifestation was performed. Skin toxic effects were assessed using version 3 of the National Cancer Institute Common Terminology Criteria (http://ctep.cancer.gov/protocolDevelopment /electronic_applications/ctc.htm), and additional drug intake was recorded. All patients participating in this study provided a written informed consent for the clinical trials.This study was conducted according to the Declaration of Helsinki Good Clinical Practice guidelines and in accordance with applicable local laws and regulations.

FCAS, MWS and CINCA could be different phenotype expressions of the same disease.

Background: Idiopathic solar urticaria (SU) is a rare type of physical urticaria, occurring immediately after exposure to visible or ultraviolet (UV) light. Treatment is based on sun avoidance and on high doses of antihistamines, but is sometimes inefficient. Methods: We report on a 41-year-old patient with severe SU who was successfully treated with a single course of 2 g/kg of intravenous immunoglobulins (IVIG). Results: A dramatic improvement in UVA and UVB tolerance was rapidly observed, with an increase of up to 10 times the UVA minimal urticarial dose on day 3. The treatment with terfenadine was continued. Healing of photosensitivity was persistent since 100 days after the single course of IVIG, no urticarian reaction was provoked with polychromatic irradiation rising above 8.3 J/cm² or after UVA doses rising above 15 J/cm². Conclusion: Use of IVIG in severe SU can be discussed when high-dose antihistamines are inefficient and quality of life is affected.