Endocrine Abstracts

Introduction: Vandetanib is a multikinase inhibitor of the family of EGF receptor inhibitors whose main indication is medullary thyroid cancer at the locally advanced or metastatic stage. It is associated with cutaneous toxicity represented mainly by acneiform eruptions and hand-foot syndrome appearing a few weeks after the start of treatment. Folliculate is rare We report a rare case of late chronic folliculate of the lower limbs secondary to vandetanib.

Observation: 77-year-old patient treated with vandetanib for an inoperable multimetastatic advanced stage (nodal, hepatic, pulmonary and bone) medullary thyroid carcinoma. Early on, he presented with a hand-foot syndrome resolved by doxycycline and topical corticosteroids. At eight months of treatment, an eruption of very inflammatory, itchy and painful papulo-pustular lesions of the lower limbs appears, made up of a polymorphic inflammatory infiltrate located around the pilosebaceous follicle on histology. Slowly favorable evolution under systemic corticosteroid therapy, doxycycline and anxiolytics.

Discussion: We report a rare case of late folliculate under vandetanib. This atypical presentation has been described in rare observations (three to date). Poorly individualized in the literature, this clinical picture is distinguished from acneiform eruptions which are early and of low intensity predominant on the face and trunk, while late folliculate preferentially sits on the limbs and its onset is delayed, the lesions are of greater size, inflammatory, with pruritus and pain.

Conclusion: Late chronic folliculate of the limbs secondary to vandetanib is rare and not very serious and can break social and family ties.

Keywords: Vandetanib, MCT, Folliculate, Lower limbs