diarrhea. Alopecia, oedema, facial erythematous rash, hair depigmentation, stomatitis, xerosis and subungueal splinter haemorrhages have been reported. Two cases of inflammation of actinic keratoses and a case of erythema multiforme subsequent to therapy with sorafenib have also been described. 3,4 We have presented a particular case which represents a unique form of dermatologic toxicity to sorafenib that has not previously been described in the literature.The use of tyrosine kinase inhibitor may result in a wide range of cutaneous side effects. Thus, it is important to know them to adapt the management of these dermatologic toxicities. References 1 Wilhelm SM, Carter C, Tang L et al. BAY 43-9006 exhibits broad spectrum oral anti-tumor activity and targets the Raf/MEK/ERK pathway and receptor tyrosine kinases involved in tumor progression and angiogenesis. Cancer Res 2004; 64: 7099-7109. 2 Clark JW, Eder JP, Ryan D, Lathia C, Lenz HJ. Safety and pharmacokinetics of the dual action Raf kinase and vascular endothelial growh factor receptor inhibitor, BAY 43-9006, in patients with advanced, refractory solid tumors. Clin Cancer Res 2005; 11: 5472-5480. 3 Lacouture ME, Desai A, Soltani K et al. Inflammation of actinic keratoses subsequent to therapy with sorafenib, a multitargeted tyrosine-kinase inhibitor.
EditorHerein, we would like to demonstrate three patients with melasma presenting punctate leucoderma after the treatment using 1064-nm Q-switched Nd:YAG laser (QSNY) with low pulse energy. A total of 259 patients (15 men, 244 women; mean age, 38 years; range, 21-67 years; Fitzpatrick skin types IV) had been treated using Figure 2 Image showing prominent follicular hyperplasia, mostly limited to the follicular isthmus, acanthosis with regenerative changes and a mild perifollicular lymphocytic inflammatory infiltration (haematoxylin-eosin. ×40).
Figure 1Image showing multiple, grouped, monomorphous, follicular keratotic, skin coloured, 1-mm papules affecting the face.
