Acneiform reaction to erlotinib

Erlotinib is a reversible inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase (TK) newly approved for the treatment of refractory, locally advanced, or metastatic nonsmall cell lung cancer. Acneiform skin reactions with EGFR inhibitors are common, with a dose-dependent skin reaction being seen in 50 to 100% of patients. This case illustrates the typical skin reaction seen with EGFR-TK inhibitors and illustrates the lack of reaction in skin with sebaceous glands that have been destroyed by radiation. Discussion of this skin reaction in the literature of dermatology is limited; this case illustrates a pattern of reaction that may suggest a mechanism for this skin reaction pattern to erlotinib.