A rare case of late-onset lichenoid photodermatitis after vandetanib therapy

Bota, James; Harvey, Valérie; Ferguson, Cynthia; Hood, Antoinette F.

doi:10.1016/j.jdcr.2015.03.008

Cited by 5 publications

(10 citation statements)

References 10 publications

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“…In all cases, these pigmentary changes remain strictly confined to UV-exposed skin areas with clear borders with non-photoexposed skin. Vandetanib-related hyperpigmentation mainly develops following inflammatory photosensitivity [6,7,8,9,11] or acne-like reactions [10], as in our second patient. Nevertheless, hyperpigmentation was associated with a prior or concomitant photosensitivity reaction in only 50% of patients in the prospective series of Giacchero et al [6].…”

Section: Discussionmentioning

confidence: 72%

“…The clinical presentation of a vandetanib-induced photosensitivity reaction is suggestive initially of a phototoxic mechanism [14]. However, several late-onset reactions have also been reported and a photoallergic origin cannot be totally ruled out [7,11,13]. Sporadic reports of photosensitivity occurring through window glass-filtered sunlight suggest that UVA radiation is the main triggering factor [2,6].…”

Section: Discussionmentioning

confidence: 99%

“…The pathophysiology of vandetanib-induced skin hyperpigmentation remains unclear, but it may be caused by accumulation of the drug, drug metabolites, iron, or complexes of drug and melanin in the skin [10,12]. Melanin incontinence with the presence of melanophages in the dermis is, however, the most frequent histopathologic change reported in this context [7,8,9,11]. In the same way, reflectance confocal microscopy imaging performed in our second patient was consistent with these histopathological findings.…”

Section: Discussionmentioning

confidence: 99%

“…More specific photoinduced manifestations have also been described with vandetanib therapy, including a single observation of subacute cutaneous lupus erythematosus [6] or several cases of lichenoid photodermatitis [6,7,8,11] (Table 1). Likewise, photodistributed erythema multiforme has been previously described in two patients [6,17].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, a prospective study reported that photosensitivity reactions affected more than a third of patients, including severe reactions that had led to treatment interruption in roughly 15% of cases [6]. However, photoinduced manifestations of vandetanib have been described only sporadically to date, and dermatologic data on this topic remain scarce [1,5,6,7,8,9,10,11]. …”

Section: Introductionmentioning

confidence: 99%

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Development of Photoonycholysis with Vandetanib Therapy

Negulescu¹,

Zerdoud

Boulinguez³

et al. 2016

Skin Appendage Disord

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Vandetanib therapy is a novel once-daily oral multitargeted tyrosine kinase inhibitor, which is currently used in advanced or metastatic medullary thyroid cancer. Skin toxicities are among the most prevalent adverse events reported with this targeted therapy (e.g. acne-like rash, hand-foot skin reaction, hair changes, and paronychia). In addition, photosensitivity reactions may affect more than one third of treated patients. We report here 2 patients developing photosensitivity reactions with vandetanib therapy, including photoonycholysis. Our patients presented a wide range of phototoxic reactions with exaggerated sunburn reactions solely located to photoexposed areas or hyperpigmentation with visible blue dots. More importantly, both patients concomitantly developed nail changes consistent with type 1 photoonycholysis, which had never been reported so far neither with vandetanib therapy nor with other anticancer-targeted therapies. In addition, histopathologic findings and reflectance confocal microscopy imaging performed in one patient suffering from photodistributed skin hyperpigmentation both strengthen the likelihood of a postinflammatory mechanism. Clinicians should be aware of these underestimated but very characteristic photoinduced adverse events, which can lead to treatment interruption and require very strict photoprotective measures in treated patients.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Development of Photoonycholysis with Vandetanib Therapy

Negulescu¹,

Zerdoud

Boulinguez³

et al. 2016

Skin Appendage Disord

View full text Add to dashboard Cite

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Vandetanib

2015

Reactions Weekly

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Diverse landscape of dermatologic toxicities from small‐molecule inhibitor cancer therapy

et al. 2021

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Background: Advances in molecular biology and genetics have contributed to breakthrough treatments directed at specific pathways associated with the development of cancer. Small-molecule inhibitors (Nibs) aimed at a variety of cellular pathways have been efficacious; however, they are associated with significant dermatologic toxicities. Methods: We conducted a comprehensive review of dermatologic toxicities associated with Nibs categorized into the following five groups: (a) mitogen-activated protein kinase; (b) growth factor/multi-tyrosine kinase; (c) cell division/DNA repair; (d) signaling associated with myeloproliferative neoplasms; and (e) other signaling pathways. Prospective phase I, II, or III clinical trials, retrospective literature reviews, systematic reviews/meta-analyses, and case reviews/reports were included for analysis.Results: Dermatologic toxicities reviewed were associated with every class of Nibs and ranged from mild to severe or life-threatening adverse skin reactions.Inflammatory reactions manifesting as maculopapular, papulopustular/acneiform, and eczematous lesions were frequent types of dermatologic toxicities seen with Nibs.Squamous cell carcinoma with keratoacanthoma-like features was associated with a subset of Nibs. Substantial overlap in dermatologic toxicities was found between Nibs.Conclusions: Dermatologic toxicities from Nibs are diverse and may overlap between classes of Nibs. Recognition of the various types of toxicities from Nibs is critical for patient care in the era of "oncodermatology/dermatopathology."

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A rare case of late-onset lichenoid photodermatitis after vandetanib therapy

Cited by 5 publications

References 10 publications

Development of Photoonycholysis with Vandetanib Therapy

Development of Photoonycholysis with Vandetanib Therapy

Vandetanib

Diverse landscape of dermatologic toxicities from small‐molecule inhibitor cancer therapy

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