Reactions Weekly | 2021
Abemaciclib
Abstract
Drug eruption: case report A 72-year-old woman developed drug eruption during treatement with abemaciclib for breast cancer. The woman, wo was diagnosed with breast cancer, had been receiving treatment with anastrozole for 5 years as an adjuvant therapy after surgery. Thereafter, the tumour recurred. Therefore, abemaciclib 150mg twice daily [route not stated] was added to the treatment. After 14 days of the initiation of abemaciclib therapy, she suddenly developed skin rashes, an elevated temperature of 39.0°C and severe fatigue. Physical examination showed generalised scattered edematous macules and papules predominantly on the trunk involving more than 30% of the body surface area. She was also noted to have eroded blisters and erosions on the lips and vulva. The laboratory testing revealed an elevated blood eosinophil rate. Histopathology showed vacuolar degeneration at the dermal-epidermal junction with spongiosis, necrotic keratinocytes and perivascular infiltration of lymphocytes. Based on the clinical presentation and laboratory findings, a differential diagnosis of erythema multiforme major or Stevens-Johnson syndrome was made. Subsequently, a final diagnosis of severe drug eruptionwas made, which was attributed to the abemaciclib therapy. The woman was immediately treated with methylprednisolone for 3 consecutive days followed by systemic prednisolone. As a result, the fatigue, pyrexia and rashes rapidly improved. Subsequently, drug-induced lymphocyte-stimulation test and patch test were performed, which showed negative results.