CASE REPORT article
Front. Oncol.
Sec. Genitourinary Oncology
This article is part of the Research TopicExploring Cutaneous Drug-Related and Drug-Associated Adverse Events: From Clinical Insight to Therapeutic ManagementView all 6 articles
Case Report: Zinc deficiency as a modifiable factor for enfortumab vedotin– induced cutaneous adverse events
Provisionally accepted
- Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
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Background: Enfortumab vedotin (EV) is effective for advanced urothelial carcinoma, but cutaneous adverse events (CAEs) remain a major barrier to treatment continuity. Intertriginous eruptions resembling symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) are particularly problematic. Zinc deficiency causes similar dermatoses, suggesting a possible link with EV-induced skin toxicity. Case Presentation: We retrospectively analyzed 10 EV-treated patients with advanced urothelial carcinoma. Serum zinc levels were measured at the onset of CAEs or dysgeusia, and all patients had subnormal zinc levels (80– 130 μg/dL). SDRIFE-like rash occurred in six patients, dry skin in five, and maculopapular rash in four. Patients with SDRIFE-like rash had significantly lower zinc levels than those without (median: 63 μg/dL vs. 70 μg/dL, P = 0.041). Zinc supplementation (100–150 mg/day, 2–4 weeks) was administered in four patients with grade ≥2 skin rash and dysgeusia. Three with SDRIFE-like rash improved within days and resolved within 14 days despite poor response to corticosteroids, whereas dry skin improved only partially and dysgeusia did not improve.
Keywords: Enfortumab vedotin, cutaneous adverse events, zinc deficiency, SDRIFE-like rash, zinc supplementation
Received: 22 Aug 2025; Accepted: 14 Nov 2025.
Copyright: © 2025 Nishizawa, Itou, Inoue, Makiguchi and Koga. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Aya Nishizawa, ayanishiza@yahoo.co.jp
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