Oh Seung Hwan, Byun Hyun Jeong, Oh Se Jin, Jun Ji-Young, Park Ji-Hye, Lee Jong Hee, Lee Dong-Youn, Lee Joo-Heung, Yang Jun-Mo
Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ann Dermatol. 2018 Aug;30(4):451-453. doi: 10.5021/ad.2018.30.4.451. Epub 2018 Jun 27.
Drug induced lichen planus like eruption is an uncommon cutaneous adverse effect of several drugs. This appears symmetric eruption of erythematous or violaceous plaques resembling lichen planus on the trunk and extremities. A 50-year-old male presented with scaly, violaceous plaques and dusky brown macules on whole body. For four months, the patient was treated with olmutinib, an oral, third-generation epidermal growth factor receptor-tyrosine kinase inhibitor. In May 2016, olmutinib received its first global approval in South Korea for the treatment of patients with locally advanced or metastatic epidermal growth factor receptor T790M mutation-positive non-small cell lung cancer. The biopsy specimen from the patient showed features of lichen planus. We diagnosed him with olmutinib-induced lichen planus like eruption. He was treated with oral methylprednisolone and topical desoxymethasone 0.25% ointment. At the same time, olmutinib dose was decreased to three-fourths of this patient's starting dose. After that, the cutaneous lesions improved.
药物性扁平苔藓样疹是多种药物罕见的皮肤不良反应。表现为躯干和四肢出现类似扁平苔藓的对称性红斑或紫红色斑块。一名50岁男性全身出现鳞屑性紫红色斑块和暗褐色斑疹。患者接受口服第三代表皮生长因子受体酪氨酸激酶抑制剂奥莫替尼治疗4个月。2016年5月,奥莫替尼在韩国首次获得全球批准,用于治疗局部晚期或转移性表皮生长因子受体T790M突变阳性的非小细胞肺癌患者。患者的活检标本显示有扁平苔藓的特征。我们诊断他为奥莫替尼诱发的扁平苔藓样疹。给予口服甲泼尼龙和外用0.25%地索奈德软膏治疗。同时,将奥莫替尼剂量减至该患者起始剂量的四分之三。此后,皮肤病变有所改善。