Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2015; 21(12): 3746-3749
Published online Mar 28, 2015. doi: 10.3748/wjg.v21.i12.3746
Cetuximab and panitumumab in a patient with colon cancer and concomitant chronic skin disease: A potential beneficial effect on psoriasis vulgaris
Ken Okamoto, Hiromichi Maeda, Takeo Shiga, Mai Shiga, Ken Dabanaka, Kazuhiro Hanazaki, Michiya Kobayashi
Ken Okamoto, Michiya Kobayashi, Department of Human Health and Medical Sciences, Kochi Medical School Hospital, Kochi 783-8505, Japan
Hiromichi Maeda, Cancer Treatment Center, Kochi Medical School Hospital, Kochi 783-8505, Japan
Takeo Shiga, Department of Dermatology, Kochi Medical School, Kochi 783-8505, Japan
Mai Shiga, Ken Dabanaka, Kazuhiro Hanazaki, Department of Surgery, Kochi Medical School, Kochi 783-8505, Japan
Author contributions: Okamoto K, Hanazaki K and Kobayashi M designed the report; Okamoto K, Shiga T, Shiga M and Dabanaka K were attending doctors for the patients and performed surgical operation; Okamoto K and Maeda H wrote the manuscript.
Ethics approval: Kochi Medical School Institutional Review Board (IRB) reviewed this study, and judged that there is no necessity to discuss this study (case report) in IRB.
Informed consent: The patient provided written informed consent for this case report.
Conflict-of-interest: There is no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Ken Okamoto, Department of Human Health and Medical Sciences, Kochi Medical School Hospital, Kohasu, Oko-cho, Nankoku-city, Kochi 783-8505, Japan.
Telephone: +81-88-8802182 Fax: +81-88-8802183
Received: October 6, 2014
Peer-review started: October 6, 2014
First decision: October 29, 2014
Revised: November 12, 2014
Accepted: December 19, 2014
Article in press: December 22, 2014
Published online: March 28, 2015

Monoclonal antibodies against epidermal growth factor receptor (EGFR) are used in the treatment of advanced colorectal cancer. However, these agents can induce severe dermatological side effects that discourage their administration in patients with chronic dermatological disease. EGFR plays a key role in normal skin development and immunological function, and is expressed in various tissues and organs, although contrarily, it is overexpressed in psoriasis-related skin lesions. Thus, discussion is ongoing regarding the putative pathological role and therapeutic potential of this protein. We herein report on a patient with advanced colon cancer and concomitant long-standing psoriasis vulgaris who received anti-EGFR antibody monotherapy as a third-line treatment for metastatic disease. One week after the initiation of treatment, the patient’s skin lesions dramatically subsided and the improvement was sustained during therapy. Based on this case, we propose that anti-EGFR antibody therapy is not necessarily contraindicated in patients with psoriasis vulgaris. Moreover, the findings reaffirmed that EGFR is an important molecule in the pathology of psoriasis.

Keywords: Psoriasis, Cetuximab, Panitumumab, Epidermal growth factor receptor, Colorectal cancer

Core tip: Anti- epidermal growth factor receptor (EGFR) antibodies are effective in treating advanced colorectal cancer. However, anti-EGFR antibodies are not generally used in patients with concomitant chronic skin disease due to dermatological toxicities. In this case report, we present a patient with psoriasis vulgaris whose symptoms lessened during treatment with anti-EGFR antibody monotherapy for metastatic colon cancer. Based on this result, we consider that patients with concomitant skin disease should still be considered for anti-EGFR antibody therapy.