Sorafenib (Nexavar; Bayer HealthCare AG) is an oral multikinase inhibitor approved by the US Food and Drug Administration for the treatment of unresectable hepatocellular carcinoma and advanced renal cell carcinoma. It inhibits multiple tyrosine kinases, including C-RAF and B-RAF, vascular endothelial growth factor receptors, and platelet-derived growth factor receptor (PDGFR).
Acute generalized exanthematous pustulosis (AGEP) is a rare skin eruption associated principally with drugs. To our knowledge, only 1 report of sorafenib-induced acute localized exanthematous pustulosis (ALEP) has been published.1 Herein, we report the first case of AGEP induced by sorafenib.
A, Eruption consisting of erythematous and edematous plaques with small pustules noted on patient’s legs. B, Erythematous plaques without pustules on patient’s neck.
Skin biopsy section showing the formation of subcorneal pustules containing neutrophil aggregates with spongiotic change in the epidermis (hematoxylin-eosin, original magnification ×200).
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