Sorafenib-associated Trichodysplasia Spinulosa versus Follicular Hyperkeratosis: a case report

Sorafenib is a multi-target kinase inhibitor used to treat advanced cancers, such as hepatocellular carcinoma. It has been associated with various cutaneous adverse events and here we report a new potential skin reaction-Trichodysplasia Spinulosa (TS)-and explore its differential diagnosis with Follicular Hyperkeratosis (FH), both possibly induced by Sorafenib. we highlight the role of sorafenib in disrupting skin keratinization process and propose a mechanism for this reaction, especially in immunosuppressed individuals.