Bullous Eruption after Off-label Use of Topical Tirbanibulin on the Chest

Tirbanibulin 1% ointment (Klisyri), an FDA-approved topical treatment for actinic keratosis, is advertised to serve as a first-in-class topical with high efficacy and low adverse effects compared to other field therapies. We report a case of severe bullous eruption associated with application of tirbanibulin in an adult female. Though application of tirbanibulin did resolve the actinic keratoses on the patient’s chest, the severe local skin reaction precludes future use of tirbanibulin in her case.