一名前列腺癌患者在阿帕鲁胺治疗期间发生急性泛发性脓疱性皮疹。
Acute generalized exanthematous pustulosis during apalutamide treatment in a patient with prostate cancer.
作者信息
Honda Tomoko, Tohi Yoichiro, Kaku Yo, Kimura Nachino, Kato Takuma, Haba Reiji, Dainichi Teruki, Sugimoto Mikio
机构信息
Department of Urology, Faculty of Medicine Kagawa University Kagawa Japan.
Department of Dermatology, Faculty of Medicine Kagawa University Kagawa Japan.
出版信息
IJU Case Rep. 2022 Aug 16;5(6):497-500. doi: 10.1002/iju5.12525. eCollection 2022 Nov.
INTRODUCTION
Acute generalized exanthematous pustulosis is a type of severe cutaneous drug adverse reaction. While apalutamide is known for its high incidence of cutaneous adverse events, it remains unknown whether acute generalized exanthematous pustulosis can develop during apalutamide treatment.
CASE PRESENTATION
A 72-year-old man with metastatic castration-sensitive prostate cancer developed small erythema on the face and trunk after 41 days of apalutamide treatment. Three days later, apalutamide was discontinued. However, 9 days after the discontinuation of apalutamide, the patient had a high fever with hemodynamic instability and showed diffuse erythema throughout the body with numerous small pustules. Skin biopsy revealed subcorneal and intraepidermal pustules admixed with many eosinophils, which led to the diagnosis of acute generalized exanthematous pustulosis. The skin rash improved in 14 days with systemic corticosteroid administration.
CONCLUSION
We present the first case of a skin rash with clinical features of acute generalized exanthematous pustulosis during apalutamide treatment.
引言
急性泛发性脓疱病是一种严重的皮肤药物不良反应。虽然阿帕他胺以其皮肤不良事件的高发生率而闻名，但在阿帕他胺治疗期间是否会发生急性泛发性脓疱病仍不清楚。
病例介绍
一名72岁转移性去势敏感性前列腺癌男性患者，在接受阿帕他胺治疗41天后，面部和躯干出现小的红斑。三天后，停用阿帕他胺。然而，在停用阿帕他胺9天后，患者出现高热伴血流动力学不稳定，全身出现弥漫性红斑并伴有大量小脓疱。皮肤活检显示角层下和表皮内脓疱，并混有许多嗜酸性粒细胞，这导致诊断为急性泛发性脓疱病。给予全身糖皮质激素治疗后，皮疹在14天内好转。
结论
我们报告了首例在阿帕他胺治疗期间出现具有急性泛发性脓疱病临床特征皮疹的病例。
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