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甲状腺癌患者凡德他尼治疗后出现罕见的皮肤光毒性皮疹:一例报告

A rare cutaneous phototoxic rash after vandetanib therapy in a patient with thyroid cancer: A case report.

作者信息

Yin Yue, Qiu Xin Ye, Zhang Yan Hua, Zhang Bin

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pharmacy.

Beijing Youan Hospital, Capital Medical University, Beijing, China.

出版信息

Medicine (Baltimore). 2019 Aug;98(31):e16392. doi: 10.1097/MD.0000000000016392.

Abstract

RATIONALE

Vandetanib is effective for treating symptomatic or progressive medullary thyroid cancer (MTC) in patients with unresectable locally advanced or metastatic disease, but its toxicity such as photosensitivity reactions should be considered. It is a rare adverse effect of this drug but might cause severe morbidity and even mortality.

PATIENT CONCERNS

A 26-year man with MTC developed phototoxic rashes on the sun-exposed areas of his shin after 15 days from the initiation of vandetanib treatment. Grade II skin toxicity was evaluated based on the Common Terminology Criteria for Adverse Events standard.

DIAGNOSES

Drug-induced phototoxic rash.

INTERVENTIONS

The vandetanib dose was reduced by 30%, and the application of topical steroids and sunscreen was adopted.

OUTCOMES

After dose reduction of vandetanib, the symptoms of vandetanib-induced phototoxic rash resolved, although residual pigmentation was observed.

LESSONS

Close attention should be paid to the adverse effect of vandetanib, phototoxic rash, and patients should be advised on the prevention and treatment measures.

摘要

理论依据

凡德他尼对治疗不可切除的局部晚期或转移性疾病患者的有症状或进展性甲状腺髓样癌(MTC)有效,但应考虑其毒性,如光敏反应。这是该药物的一种罕见不良反应,但可能导致严重发病甚至死亡。

患者情况

一名26岁的MTC男性患者在开始凡德他尼治疗15天后,其小腿暴露于阳光下的部位出现光毒性皮疹。根据不良事件通用术语标准评估为II级皮肤毒性。

诊断

药物性光毒性皮疹。

干预措施

凡德他尼剂量减少30%,并采用局部使用类固醇和涂抹防晒霜的方法。

结果

凡德他尼剂量减少后,凡德他尼引起的光毒性皮疹症状消退,尽管仍观察到色素沉着。

经验教训

应密切关注凡德他尼的不良反应——光毒性皮疹,并应向患者提供预防和治疗措施的建议。

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