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Necrolytic Migratory Erythema–like Skin Lesion During Gefitinib Treatment A Rare Cutaneous Adverse Reaction

Jun Young Seong, MD1; Sook Hyun Kong, MD1; Yu Sung Choi, MD, PhD1; Ho Seok Suh, MD, PhD1
[+] Author Affiliations
1Department of Dermatology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
JAMA Dermatol. 2016;152(8):947-948. doi:10.1001/jamadermatol.2016.1098.
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This case report describes the occurrence of a necrolytic migratory erythema–like skin lesion after treatment with gefitinib.

Gefitinib is an orally administered epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor used to treat non–small-cell lung cancer (NSCLC).1 The expression of EGFR is strong in epidermis and epidermal appendages, as well as in tumor cells, and so treatment with gefitinib can result in dermatologic adverse effects with various manifestations.1 We report a case of necrolytic migratory erythema (NME)-like skin lesions developing during treatment with gefitinib. We believe that this case demonstrates a rare cutaneous adverse reaction to gefitinib and highlights the need for suspicion of this rare condition during the course of treatment with gefitinib.

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Figure 1.
Clinical Presentation

Localized, migratory, coalescing, eroded, erythematous plaques with scales on both lower extremities, especially the perineal and inguinal areas.

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Figure 2.
Punch Biopsy Specimen From a Right Thigh Lesion

This specimen from the edge of the erythematous plaque shows hyperkeratosis and parakeratotic scale, accompanied by upper epidermal pallor, absence of the granular layer, and mild superficial perivascular lymphocytic infiltrate; dilated blood vessels can also be seen in the superficial dermis (hematoxylin-eosin, original magnification ×100).

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