Pazopanib
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Neutrophilic eccrine hidradenitis: case report A 34-year-old woman developed neutrophilic eccrine hidradenitis (NEH) during treatment with pazopanib for uterine adenocarcinoma. The woman, who had uterine adenocarcinoma for 2 years and had received six cycles of chemotherapy comprising cisplatin and ifosfamide, was hospitalised. About 3 months prior to hospitalisation, she had started experiencing abdominal pain, fever and haematuria. She was found to have tumour recurrence with invasion to the bladder. Excision of the recurrent pelvic adenosarcoma was performed, and she started receiving pazopanib 800 mg/day [route not stated]. Following 9 weeks of pazopanib therapy, she developed tender erythematous rashes on the bilateral thighs associated with fever. With the suspicion of cellulitis the pazopanib therapy was stopped, and the woman was hospitalised. She was treated with oxacillin followed by amoxicillin/clavulanic-acid. Afterwards, her treatment was escalated to teicoplanin and amikacin. However, the skin lesions progressed and the fever persisted even after 1 week of antibiotic therapy. Physical examination performed at that time showed several well‑demarcated, erythematous, oedematous, tender plaques of varying sizes on the bilateral thighs. The plaques showed no epidermal changes. Histological examination of the skin sample taken from one of the left thigh lesions showed mild acanthosis, mild hyperkeratosis, perivascular lymphocytic infiltrate with neutrophils, papillary oedema and focal extravasation of erythrocytes in the dermis. Lymphocytes and neutrophils infiltration was also observed in the sweat glands. The lumens of the sweat glands were infiltrated by neutrophils. Finally, she was diagnosed with NEH. Therefore, her antibiotic therapy was stopped, and her treatment was started with methylprednisolone. Consequently, the skin lesions and fever resolved, with only residual hyperpigmentation. After recovery, pazopanib was restarted. Consequently, the woman developed recurrent skin lesions 3 weeks later. She was again treated with methylprednisolone. Following a subsequent 3 month long pazopanib therapy, she had no recurrent rashes. Wang F-Y, et al. Pazopanib as a new culprit in neutrophilic eccrine hidradenitis. Dermatologica Sinica 37: 222-225, No. 4, Oct-Dec 2019. Available from: URL: http:// 803448769 doi.org/10.4103/ds.ds_6_19
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Reactions 25 Jan 2020 No. 1788
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