title: Erlotinib-induced rash spares previously irradiated skin.
abstract: BACKGROUND
  Erlotinib is an epidermal growth factor receptor inhibitor prescribed to patients with locally advanced or metastasized non-small cell lung carcinoma after failure of at least one earlier chemotherapy treatment. Approximately 75% of the patients treated with erlotinib develop acneiform skin rashes.
  
  
  METHODS
  A patient treated with erlotinib 3 months after finishing concomitant treatment with chemotherapy and radiotherapy for non-small cell lung cancer is presented. Unexpectedly, the part of the skin that had been included in his previously radiotherapy field was completely spared from the erlotinib-induced acneiform skin rash.
  
  
  CONCLUSIONS
  The exact mechanism of erlotinib-induced rash sparing in previously irradiated skin is unclear. The underlying mechanism of this phenomenon needs to be explored further, because the number of patients being treated with a combination of both therapeutic modalities is increasing. The therapeutic effect of erlotinib in the area of the previously irradiated lesion should be assessed.
authors.affiliation: Department of Radiation Oncology, Radiotherapeutisch Instituut Stedendriehoek en Omstreken (RISO), Deventer, The Netherlands.
authors.forename: Irene M
authors.initials: IM
authors.lastname: Lips
authors.forename: Mariska E Y
authors.initials: ME
authors.lastname: Koster
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Houwing
authors.forename: Ernest J A
authors.initials: EJ
authors.lastname: Vonk
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D018450:Disease Progression; D019583:Dose Fractionation, Radiation; D003875:Drug Eruptions / Q000209:etiology* / Q000503:physiopathology*; D000069347:Erlotinib Hydrochloride; D017809:Fatal Outcome; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009367:Neoplasm Staging; D010997:Pleural Neoplasms / Q000188:drug therapy*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011799:Quinazolines / Q000009:adverse effects* / Q000627:therapeutic use; D011855:Radiodermatitis / Q000150:complications* / Q000503:physiopathology*; D018714:Radiotherapy, Adjuvant; D014057:Tomography, X-Ray Computed
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride