Toxic Erythema of Chemotherapy in Enfortumab Vedotin Presenting as Pseudocellulitis Limited to the Lower Extremities: A Case Series and Review of the Literature
Abstract
Enfortumab vedotin (EV) is an antibody-drug conjugate used as a second- or third-line therapy for patients with urothelial carcinoma. Adverse cutaneous reactions have been reported for nearly half of patients on EV. These reactions include severe cutaneous adverse reactions (SCARs), and they range from idiosyncratic hypersensitivity reactions to toxic erythema. We report three cases of patients with invasive/metastatic urothelial carcinoma treated with EV who presented with toxic erythema of chemotherapy with large bulla formation limited to the distal lower extremities. These cases are notable for their unique distribution of lesions and clinical resemblance to cellulitis, resulting in antibiotic treatment prior to dermatology consult in two of the three cases. Additionally, all three cases resolved with high potency topical steroid treatment and the therapeutic drainage of intact bullae. Finally, patients in two out of the three cases were able to retrial EV at a reduced dose or altered dosing schedule. Thus, this case series highlights a unique morphologic cutaneous toxicity to EV.
Keywords: Toxic erythema of chemotherapy, enfortumab vedotin, antibody-drug conjugate, pseudocellulitis
How to Cite:
Kaufman, L., Libson, K., Hoffman, K., Chung, C. G., Kaffenberger, B. H. & Dulmage, B., (2026) “Toxic Erythema of Chemotherapy in Enfortumab Vedotin Presenting as Pseudocellulitis Limited to the Lower Extremities: A Case Series and Review of the Literature”, Academic Dermatology 4(1), 1-7. doi: https://doi.org/10.18061/ad.5781
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