MARY S.STONEMDSOONBAHRAMIMDCARRIE ANN R.CUSACKMDSENAIT W.DYSONMDMOLLY A.HINSHAWMDARNI K.KRISTJANSSONMD
Histopathologic examination of the skin biopsy specimen showed dense, mixed inflammation predominantly consisting of neutrophils around a ruptured hair follicle, compatible with a suppurative folliculitis. Cultures from a pustular lesion revealed no organisms. A diagnosis of cutaneous adverse effects associated with EGFR inhibitors was made.
The patient was prescribed hydrocortisone acetate cream, 2%, and metronidazole gel, 0.75%, to be applied to papulopustular lesions and was encouraged to use an emollient and sunscreen. Mupirocin ointment was applied around nail folds. She had to trim her eyelashes with scissors on a weekly basis. Despite continuing treatment with erlotinib, the papulopustular eruption improved over time. Her other cutaneous toxic reactions persisted over a 4-month follow-up.
Papulopustular Eruptions in a 32-Year-Old Woman After Lung Cancer Treatment—Diagnosis. Arch Dermatol. 2011;147(6):735-740. doi:10.1001/archdermatol.2011.127-b