Cutaneous adverse reactions associated to apalumide: two case reports of DRESS syndrome and maculopapular exanthema

Apalutamide, an oral androgen receptor signaling inhibitor approved for the treatment of prostate cancer, has been associated with frequent occurrence of cutaneous adverse events (CAE) during pivotal SPARTAN and TITAN studies, in 24% and 27% of the patients, respectively [1,2].However, side effects are gathered under the umbrella term 'rash' , which can encompass a wide number of dermatoses with various prognosis.Postmarketing follow-up usually allows a better classification of those CAE.Apalutamide is mainly responsible for benign maculo-papular exanthema (MPE), xerosis, lichenoid reactions [3][4][5].But potentially life threating condition such as acute generalized exanthematous pustulosis [6], DRESS [7,8] or toxic epidermal necrolysis [3] have been described in the literature.We report two cases from our clinic illustrating the clinical spectrum of the CAE.