Purpuric Drug Eruptions Caused by Epidermal Growth Factor Receptor Inhibitors for Non-Small Cell Lung Cancer: A Clinicopathologic Study of 32 Cases.

摘要: Importance Purpuric skin lesions have only rarely been reported in patients receiving epidermal growth factor receptor inhibitors. However, their clinical and histopathologic presentations varied considerably. Objective To characterize purpuric eruptions caused by Design, Setting, Participants This prospective study enrolled 32 who presented to an integrated dermato-oncologic clinic a tertiary referral medical center with after using inhibitors from January 1, 2013, through December 31, 2015. Exposures Epidermal tyrosine kinase inhibitors, including gefitinib, erlotinib, afatinib. Main Outcomes Measures Clinical presentations, features, laboratory examinations, treatment outcomes of drug eruptions. Results Thirty-two patients, 14 without pustules (mean [SD] age, 60 [11] years; 12 female 2 male) 18 64 6 male), were identified. The median time development was 3.5 months. characterized macules, papules, confluent plaques predominantly on the lower extremities. Pustules various sizes could be found (56%). Eleven (34%) had that covered places other than Eczema craquele–like features developed 13 (41%). Bacterial pathogens frequently identified these lesions. Among them,Staphylococcus aureuswas most predominant 20 (63%), commonly those cutaneous pustules. dysmaturation, neutrophil exocytosis, perivascular infiltration lymphocytes neutrophils, red blood cell extravasation, plumping endothelium main features. expressions filaggrin human β-defensin lesional markedly reduced. All improved at least 1 week systemic antibiotic treatment; doses also changed for (44%). Conclusions Relevance are uncommon characteristic presentations. role bacterial this reaction is important requires further exploration.