Sorafenib-Induced Facial Acneiform Eruption

Sorafenib, a multikinase inhibitor used for treating hepatocellular carcinoma, was known to cause cutaneous adverse events like alopecia and hand-foot skin reactions. However, acneiform eruptions were rare and typically associated with high doses. This document reported a case where a patient on low-dose sorafenib developed a severe facial acneiform eruption without other skin reactions. The condition was treated with topical clindamycin and tretinoin, resulting in some improvement. The acneiform eruption at low doses was previously unreported, and its mechanism might involve indirect epidermal growth factor receptor inhibition or direct cytotoxic effects on eccrine glands. Topical treatments offered minimal improvement, and discontinuation of sorafenib was generally unnecessary unless in special cases.