Tone Yuki, Matsui Mami, Park Aeri, Otani Saki, Shiba Mizuki, Okano Fumisa, Sugitani Iwao, Kanda Naoko, Saeki Hidehisa, Hoashi Toshihiko
Department of Dermatology, Nippon Medical School, Bunkyo-Ku, Tokyo, Japan.
Department of Endocrine Surgery, Nippon Medical School, Bunkyo-Ku, Tokyo, Japan.
J Dermatol. 2025 Jun;52(6):1066-1069. doi: 10.1111/1346-8138.17749. Epub 2025 Apr 16.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis are fatal adverse skin reactions characterized by high fever, epidermal detachment, and mucositis. Selpercatinib is a highly selective inhibitor of tyrosine kinase, rearranged during transfection (RET), and is the first targeted therapy for solid tumors with RET gene alteration. The main adverse events of selpercatinib include hypertension, liver dysfunction, diarrhea, and QT prolongation on electrocardiograms. We present the case of 50-year-old male with medullary thyroid carcinoma who was treated with selpercatinib. On the 12th day of the treatment, he developed widespread erythema, which resulted in a referral to our department. Physical examination revealed disseminated erythematous macules, conjunctival congestion, and bloody crusting of the lips, and histopathological examination showed single-cell necrosis in epidermis. Based on these findings, he was diagnosed with SJS. After the discontinuation of selpercatinib and systemic administration of corticosteroids, his symptoms were improved. The patient showed positivity for selpercatinib in drug lymphocyte stimulation test, suggesting the diagnosis of SJS induced by selpercatinib. To the best of our knowledge, this is the first report of SJS caused by selpercatinib. We herein present and discuss this case to raise awareness.
史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症是致命的皮肤不良反应，其特征为高热、表皮剥脱和黏膜炎症。塞尔帕替尼是一种高度选择性的酪氨酸激酶抑制剂，在转染过程中发生重排（RET），是首个用于治疗RET基因改变的实体瘤的靶向疗法。塞尔帕替尼的主要不良事件包括高血压、肝功能障碍、腹泻以及心电图QT间期延长。我们报告了一名50岁男性甲状腺髓样癌患者接受塞尔帕替尼治疗的病例。在治疗的第12天，他出现了广泛的红斑，随后转诊至我科。体格检查发现散在的红斑性斑疹、结膜充血和嘴唇血痂，组织病理学检查显示表皮单细胞坏死。基于这些发现，他被诊断为SJS。停用塞尔帕替尼并全身应用糖皮质激素后，他的症状有所改善。患者在药物淋巴细胞刺激试验中对塞尔帕替尼呈阳性反应，提示诊断为塞尔帕替尼诱导的SJS。据我们所知，这是首例关于塞尔帕替尼引起SJS的报告。我们在此呈现并讨论该病例以提高认识。
