Acute “asteatotic” dermatitis induced by pazopanib and nivolumab in a patient with clear cell renal cell carcinoma

Abstract

Abstract. Introduction: Scientific research on cancer biology in the past few decades has enabled the development of multiple different types of new anticancer drugs. These therapeutic agents include tyrosine kinase inhibitors, monoclonal antibodies, and immunotherapies. They are significantly more precise than classical chemotherapies, but frequently induce adverse effects. Cutaneous side effects are the most frequently observed ones, and when they are severe or prolonged in time, they eventually lead to 
morbidity, dose modification or drug discontinuation. They significantly affect the quality of life in patients, medication adherence, elevate infection risk, resulting in high economic burden and many hospital visits for cancer patients. Case Presentation: We report a case of severe acute asteatotic dermatitis in a 54-year-old male patient induced by pazopanib and nivolumab for the treatment of clear cell renal cell carcinoma. After treatment, the erythema faded, desquamation and xerosis were significantly reduced. Systemic oncology therapy was switched to M-TOR inhibitor everolimus. The patient maintains mild generalized skin xerosis, but is using topical emollient cream daily and topical corticosteroids occasionally for maintenance. The patient is being followed up. Conclusion: The use of tyrosine kinase inhibitors and immunotherapy is constantly increasing, and dermatologists care for a growing number of cancer  patients with cutaneous adverse events with different pathogenesis and complexity in comparison to the classical dermatoses. This leads to the need for a collaboration between dermatologists and oncologists.