Acneiform eruptions associated with epidermal growth factor receptor-targeted chemotherapy.
A relatively newer class of chemotherapy agents, known as the epidermal growth factor receptor inhibitors (EGF-RIs), is being used to treat advanced stages of solid tumors. Acneiform eruptions are a frequent adverse effect and one which has been associated with increased survival in some studies. We describe 3 patients who presented shortly after initiation of EGF-RI therapy. Characteristics included an absence of comedones, facial and truncal involvement, and a perifollicular lymphoneutrophilic infiltrate detected on biopsy. Lesion counts were reduced with topical adapalene and oral tetracyclines in two patients. Patient 3 had dramatic clearance with low-dose isotretinoin (20 mg daily) until completion of EGF-RI therapy. Acneiform eruptions are a common adverse reaction to EGF-RI therapy and can be treated with traditional acne therapy. This should not be considered a drug hypersensitivity eruption or allergy, and patients should continue therapy. For patients with severe eruptions, oral isotretinoin is a consideration.
DeWitt
Christine A
CA
Division of Dermatology, Southern Illinois University, Springfield, IL 62794-9644, USA.
Siroy
Alan E
AE
Stone
Stephen P
SP
D000152:Acne Vulgaris / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D000068816:Adapalene; D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003110:Colonic Neoplasms / Q000188:drug therapy; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage / Q000627:therapeutic use; D009281:Naphthalenes / Q000008:administration & dosage / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D003879:Dermatologic Agents; D009281:Naphthalenes; D000068816:Adapalene; D066246:ErbB Receptors; D015474:Isotretinoin; D008911:Minocycline