JAAD Case Reports | 2021
A rare presentation of enfortumab vedotin–induced toxic epidermal necrolysis
Abstract
MMAE: monomethyl auristatin E SCORTEN: score of toxic epidermal necrolysis SJS: Stevens-Johnson syndrome TEN: toxic epidermal necrolysis INTRODUCTION Enfortumab vedotin is a novel treatment for metastatic urothelial carcinoma. In 2019, the United States Food and Drug Administration approved the drug as a third-line treatment for patients who had failed in previous trials of programmed cell death protein 1 and platinumbased chemotherapeutic agents. The drug has demonstrated to have a significant response rate in early phase trials and is known for its tolerable side-effect profile. The adverse effects of enfortumab vedotin include fatigue, peripheral neuropathy, alopecia, and rash. The most frequently reported rashes were characterized as diffuse ‘‘maculopapular.’’ All side effects were managed on an outpatient basis. Toxic epidermal necrolysis (TEN) is a lifethreatening mucocutaneous reaction that involves more than 30% of the skin. TEN is not a recognized side effect of enfortumab vedotin. However, we present a rare case of enfortumab vedotineinduced TEN in a 72-year-old man with metastatic urothelial carcinoma.