Acne Inversa-like Lesions Induced by a Low Dose of Sorafenib

摘要

Sorafenib is an oral multikinase inhibitor approved for the treatment of unresectable hepatocellular carcinoma, differentiated thyroid cancer, and advanced renal-cell carcinoma. This drug blocks tumor cell proliferation and angiogenesis by inhibiting the Raf serine/threonine kinases (RAF1 and BRAF) as well as multiple receptor tyrosine kinases [1]. Adverse skin reactions occur in up to 90% of patients. Although acneiform eruptions have been widely reported in association with epidermal growth factor receptor (EGFR) inhibition, ranging from 24%–91% of patients, those induced by sorafenib are rare. They usually appear in the first 6 weeks after drug onset and are located on the face. Regarding clinical-pathological characteristics, acneiform eruptions induced by sorafenib are classified into 3 groups: papulopustular eruptions without associated retention lesions, nodular-cystic eruptions, and perforating folliculitis [2]. Of these groups, papulopustular facial eruptions have been the most frequently observed. Here we report a case of acne inversa-like lesions induced by a low dose of sorafenib in a 62-year-old man with hepatocellular carcinoma.