Nodular-Cystic Eruption During Sorafenib Treatment for Hepatocarcinoma: An Unconventional Skin Reaction Requiring Unconventional Treatment

Sorafenib, used for advanced hepatocellular carcinoma, was linked to significant skin toxicity, including rare follicular involvement. A 55-year-old man developed painful nodular-cystic lesions during treatment. Traditional treatments failed, but photodynamic therapy (PDT) led to clinical improvement without systemic side effects. While PDT did not prevent new lesions, it reduced symptoms and improved the patient's quality of life, allowing continued cancer treatment. This case suggested PDT as a potential option for managing severe skin toxicity when standard therapies were ineffective.