Pityriasis rubra pilaris-like erythroderma secondary to phosphoinositide 3-kinase inhibition

Clin Exp Dermatol. 2018 Dec;43(8):890-894. doi: 10.1111/ced.13608. Epub 2018 May 30.

Abstract

Background: Phosphoinositide 3-kinase (PI3K) inhibitors are a class of small-molecule inhibitors approved for the treatment of certain leukaemias and lymphomas. Their dermatological adverse event profile is poorly described.

Aim: To characterize a rare cutaneous adverse event from PI3K inhibitors in order to help dermatologists and oncologists identify and effectively manage such eruptions.

Methods: This was a retrospective analysis of patients receiving PI3K inhibitors referred to the Skin Toxicities Program in The Center for Cutaneous Oncology.

Results: Three patients on PI3K inhibitors for treatment of malignancy developed diffuse erythroderma and keratoderma. Clinical and histopathological findings were consistent with pityriasis rubra pilaris (PRP)-like reactions. All patients improved with topical and oral corticosteroids, oral acitretin, and drug discontinuation.

Conclusions: PRP-like cutaneous eruptions may develop secondary to PI3K inhibition. Early dermatological evaluation of cutaneous toxicities to PI3K inhibitors as well as rapid initiation of disease-specific treatments may help keep patients on life-prolonging anti-cancer therapies.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Dermatitis, Exfoliative / chemically induced*
  • Dermatitis, Exfoliative / pathology
  • Female
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy
  • Male
  • Middle Aged
  • Oligodendroglioma / drug therapy
  • Phosphoinositide-3 Kinase Inhibitors*
  • Pityriasis Rubra Pilaris / chemically induced*
  • Pityriasis Rubra Pilaris / pathology
  • Protein Kinase Inhibitors / adverse effects*
  • Protein Kinase Inhibitors / therapeutic use
  • Retrospective Studies
  • Skin / pathology

Substances

  • Antineoplastic Agents
  • Phosphoinositide-3 Kinase Inhibitors
  • Protein Kinase Inhibitors