Erlotinib-induced florid acneiform rash complicated by extensive impetiginization

Erlotinib (Tarceva) is an epidermal growth factor receptor (EGFR) inhibitor, a member of a new group of molecular targeted drugs that combine high efficacy against tumours with less, often self-limiting, toxicity, compared with traditional chemotherapeutics. It is used for treatment of solid-organ tumours, especially as second- or third-line therapy for non-small-cell lung cancer. Dose-related cutaneous side-effects and diarrhoea may be a significant obstacle to treatment compliance. We present two cases with long-lasting acneiform eruptions, complicated by significant impetiginization, resulting in hospitalization in one case. The other patient suffered from sleep-disturbing, itching crusts on the scalp. As the use of EGFR inhibitors is increasing, clinicians should be aware of their side-effects. Early and timely dermatological intervention may diminish adverse events for patients treated with these agents and improve quality of life.