Crvenkova Simonida, Popova Maja, Crvenkova Labina, Lazarevska Antonija
1Faculty of Medicine, University Clinic of Radiotherapy and Oncology, Skopje, Macedonia.
2Faculty of Medicine, University Clinic of Cardiology, Skopje, Macedonia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2024 Dec 12;45(3):77-84. doi: 10.2478/prilozi-2024-0025. Print 2024 Nov 1.
To investigate the rare side effects of Osimertinib in a case of toxic epidermal necrosis.
We report on a case of a 44-year old woman with lung adenocarcinoma harboring an EGFR-sensitizing mutation who was treated with Osimertinib as the second-line treatment. Ten days after Osimertinib initiation, a diffuse erythematous rash rapidly spread over the patient's trunk along with vesicles and purpuric macules; furthermore, she developed erythema and exfoliation on the face and trunk and severe mucositis. Toxic epidermal necrolysis (TEN) is life-threatening dermatologic adverse event, caused by a delayed-type drug hypersensitivity reaction. Although skin toxicity is common during treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), Osimertinib-associated TEN is very rare.
Treatment with systemic steroids and immunoglobulin as well as supportive treatment led to an improvement of her general wellbeing, followed by a remarkable recovery.
Although the clinical use of Osimertinib is becoming widespread, the side effects may not be fully understood. Clinicians should indeed pay more attention to the occurrence of side effects and be prepared to deal with them in timely manner.
在一例中毒性表皮坏死病例中研究奥希替尼罕见的副作用。
我们报告一例44岁患有肺腺癌且携带表皮生长因子受体（EGFR）敏感突变的女性患者，接受奥希替尼作为二线治疗。开始使用奥希替尼10天后，弥漫性红斑皮疹迅速蔓延至患者躯干，伴有水疱和紫癜性斑疹；此外，她面部和躯干出现红斑和脱屑，并有严重的口腔炎。中毒性表皮坏死松解症（TEN）是一种由迟发型药物超敏反应引起的危及生命的皮肤不良事件。虽然在表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗期间皮肤毒性很常见，但奥希替尼相关的TEN非常罕见。
全身使用类固醇和免疫球蛋白治疗以及支持治疗使她的总体健康状况得到改善，随后显著康复。
尽管奥希替尼的临床应用越来越广泛，但其副作用可能尚未被完全了解。临床医生确实应更加关注副作用的发生，并准备好及时处理。
