Ann Dermatol.  2018 Aug;30(4):451-453. 10.5021/ad.2018.30.4.451.

Olmutinib Induced Lichen Planus Like Eruption

• Oh SH
• Byun HJ
• Oh SJ
• Jun JY
• Park JH
• Lee JH
• Lee DY
• Lee JH
• Yang JM

• KMID: 2457522
• DOI: http://doi.org/10.5021/ad.2018.30.4.451

Abstract

Drug induced lichen planus like eruption is an uncommon cutaneous adverse effect of several drugs. This appears symmetric eruption of erythematous or violaceous plaques resembling lichen planus on the trunk and extremities. A 50-year-old male presented with scaly, violaceous plaques and dusky brown macules on whole body. For four months, the patient was treated with olmutinib, an oral, third-generation epidermal growth factor receptor-tyrosine kinase inhibitor. In May 2016, olmutinib received its first global approval in South Korea for the treatment of patients with locally advanced or metastatic epidermal growth factor receptor T790M mutation-positive non-small cell lung cancer. The biopsy specimen from the patient showed features of lichen planus. We diagnosed him with olmutinib-induced lichen planus like eruption. He was treated with oral methylprednisolone and topical desoxymethasone 0.25% ointment. At the same time, olmutinib dose was decreased to three-fourths of this patient's starting dose. After that, the cutaneous lesions improved.

Keyword

Drug eruptions; EGFR tyrosine kinase inhibitor; Lichen planus; Olmutinib

MeSH Terms

Biopsy
Carcinoma, Non-Small-Cell Lung
Desoximetasone
Drug Eruptions
Epidermal Growth Factor
Extremities
Humans
Korea
Lichen Planus*
Lichens*
Male
Methylprednisolone
Middle Aged
Phosphotransferases
Receptor, Epidermal Growth Factor
Desoximetasone
Epidermal Growth Factor
Methylprednisolone
Phosphotransferases
Receptor, Epidermal Growth Factor

Figure

• 

  Fig. 1 (A) Scaly, violaceous to black-colored plaques and dusky brown macules on trunk. (B) Same lesions are at both thighs and calves. However, popliteal areas were spared.

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  Fig. 2 Histopathological images of skin biopsy. (A) Orthokeratosis, wedge-shaped hypergranulosis, saw-toothed irregular elongated rete ridges in the epidermis. Max-Joseph spaces are shown (blue arrows). Lichenoid lymphocytic infiltration in the dermis (H&E, ×40). (B) Dyskeratotic cells in the epidermis (red arrow) (H&E, ×200).

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