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CC BY 4.0 · Indian J Med Paediatr Oncol 2024; 45(02): 183-187
DOI: 10.1055/s-0043-1766136
Case Report with Review of Literature

Sorafenib-Induced Spiny Follicular Hyperkeratosis: A Case Report with Review of Literature

Chandana Shajil
1   Department of Dermatology, Venereology and Leprology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
,
Dharshini Sathishkumar
1   Department of Dermatology, Venereology and Leprology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
,
Deepthi Boddu
2   Paediatric Haematology/ Oncology, Department of Paediatrics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
,
Ramesh Babu Telugu
3   Department of Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
› Author Affiliations Funding None declared.
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Abstract

Sorafenib is a multikinase inhibitor used in the treatment of various solid tumors. Mucocutaneous adverse events are experienced by 70 to 90% of the patients receiving sorafenib, underscoring the importance of awareness among oncologists and dermatologists. Spiny follicular hyperkeratosis (SFH) is a benign and rarely reported skin reaction linked to sorafenib. It is characterized by flesh-colored or white, follicular hyperkeratotic spicules, preferentially involving the face, scalp, upper trunk, and upper arms. Besides being acknowledged as a paraneoplastic cutaneous manifestation of multiple myeloma, SFH has also been linked to a few diseases and drugs, other than sorafenib. However, the precise etiopathogenesis remains to be elucidated. We report an interesting case of SFH in a 14-year-old child, 1 week following the initiation of sorafenib. Trichodysplasia spinulosa, multiple minute digitate hyperkeratosis, keratosis pilaris, filiform warts, and pityriasis rubra pilaris are morphologically similar conditions that were excluded by clinicopathological correlation. A complete resolution of skin rash following sorafenib dose reduction further reinforced our diagnosis. Our patient also developed hand-foot skin reaction, facial erythema, and eruptive nevi during treatment. The regrowth of curly hair following chemotherapy-induced anagen effluvium was an interesting development in our case. We report this case to familiarize clinicians with this rare entity.

Keywords

adverse events - sorafenib - spiny follicular hyperkeratosis

Declaration of Patient Consent

We certify that patient's consent was obtained for publication of her images and other clinical information, in an appropriate consent form. The patient understands that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.




Publication History

Article published online:
12 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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