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Unique presentations of epidermal growth factor receptor inhibitor-induced papulopustular eruption related to

Lauren Elyse Wiznia1, Jennifer Nam Choi

  • 1Yale University School of Medicine, New Haven, CT, USA.

Dermatology Online Journal
|April 5, 2013
PubMed

Insights

Epidermal growth factor receptor (EGFR) inhibitors can cause skin issues. This study details two unique cases of EGFR inhibitor-induced papulopustular eruption with Staphylococcus aureus superinfection, successfully treated with antibiotics and steroids.

Area of Science:

  • Dermatology
  • Oncology
  • Pharmacology

Background:

  • Epidermal growth factor receptor (EGFR) inhibitors are crucial in cancer therapy.
  • EGFR inhibitors commonly cause cutaneous side effects, including papulopustular eruptions.
  • These eruptions typically affect the face, scalp, and chest with sterile pustules, but bacterial superinfection can occur.

Observation:

  • Two unique cases of EGFR inhibitor-induced papulopustular eruption are presented.
  • Case 1: Abrupt onset of confluent erythematous plaques with pinpoint pustules on the face and neck.
  • Case 2: Long-standing scalp eruption with erythema, thick crusts, pustular exudate, and alopecia.

Findings:

  • Both patients presented with Staphylococcus aureus superinfection complicating the papulopustular eruption.
  • The pustules, typically sterile, were found to be infected with S. aureus in these cases.
  • Both unique presentations resolved rapidly with a combination of oral non-tetracycline antibiotics and topical steroids.

Implications:

  • Highlights the potential for bacterial superinfection in EGFR inhibitor-induced papulopustular eruptions.
  • Emphasizes the importance of identifying and treating S. aureus superinfection for effective management.
  • Suggests that prompt antibiotic and topical steroid treatment can lead to rapid resolution of these complex cutaneous reactions.

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