PMC6134951_01
(A) Morbilliform skin rash on the face, sole, palm, and legs. (B) Skin pathology of punch biopsy on right arm showing spongiotic and interface dermatitis with eosinophils, consistent with drug eruption. Left: 40x magnification; right: 200x magnification; (C) CT chest images before and 8 weeks after brigatinib treatment. (D) Chemical structures of alectinib (left) and brigatinib (right). Structure pictures of alectinib and brigatinib were downloaded from PubChem database.
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However, 10 days later, she developed a non-pruritic morbilliform rash spreading from trunk to the entire body, including palms, soles, and face with mild lip and eye swelling (Figure 1A). A right arm lesion was punch biopsied, showing spongiotic and interface dermatitis with eosinophils, consistent with drug eruption (delayed type IV hypersensitivity, Figure 1B). Eight weeks later, rescanning showed markedly improved pleural effusion and tumor response (Figure 1C).