Sorafenib-induced Palmoplantar Hyperkeratosis

Sorafenib is an oral multikinase inhibitor used in the treatment of renal cell carcinoma. As with single kinase inhibitors, cutaneous adverse events have been reported with sorafenib, specifically a hand-foot reaction complicated by hyperkeratosis. The authors highlight the case of a 51-year-old Caucasian woman treated for metastatic renal cell carcinoma who presented with well-defined tender erythematous callosities of the fingers and feet, following a dosage increase of sorafenib. A dose reduction decreased the symptoms, but the hyperkeratosis persisted. This adverse response may represent a novel event differing from traditional hand-foot syndrome.