Stevens-Johnson syndrome induced by sorafenib for therapy of HCC: A case report

Abstract

A 74-year-old Japanese male, suffering from stage IVA hepatocellular carcinoma (HCC) with subcarinal lymph node metastasis, was hospitalized for the sorafenib therapy. His hepatic reserve function was assessed as Child-Pugh score 5 and Liver damage grade A. Sorafenib was administered by 800 mg per day. On day 14, just after the development of fever, because erythematous lesions appeared in his trunk, the administration of sorafenib was immediately withdrawn under suspicion for erythema multiforme. However, on day 16, erythema expanded over his limbs and multiple erosions appeared in oral mucosa. Consequently, he was diagnosed as Stevens-Johnson syndrome and treated with prednisolone (20 mg/day). On day 31, his skin lesions disappeared and the fever went down, so prednisolone was withdrawn. When skin lesions are noticed during the sorafenib treatment, we should pay attention to Stevens-Johnson syndrome which is rare but serious, in addition to hand-foot skin reaction which is common for sorafenib.