2022 Volume 21 Issue 3 Pages 212-218
A 79-year-old man was diagnosed with prostate cancer three months before his first visit to our department. Contrast-enhanced CT and whole-body magnetic resonance imaging with diffusion weighted imaging revealed prostate cancer with multiple bone and lymph node metastases. One month prior to his first visit to our department, he was started on apalutamide (a combination of calcium carbonate, cholecalciferol, and magnesium carbonate) and denosumab. One week before his first visit to our department, erythema appeared on his lower extremities and gradually spread to his trunk, so he was referred to our department. Considering the possibility of drug eruption caused by apalutamide, we reduced the dose of apalutamide and started oral olopatadine hydrochloride and topical steroids, but the skin rash continued to spread. One week later, we discontinued apalutamide and started 15 mg of oral prednisolone daily. The skin lesions resolved within three weeks without discontinuation of other medications. Apalutamide is a drug that produces a high rate of skin rash and rarely can cause severe drug eruptions such as toxic epidermal necrolysis. The mechanism of apalutamide-induced drug eruption is unknown. Dermatologists must be aware of symptoms of severe cutaneous adverse reactions of patients treated with apalutamide. Skin Research, 21 : 212-218, 2022
