title: Late epidermal growth factor receptor inhibitor-related papulopustular rash: a distinct clinical entity.
abstract: We report four patients developing a late form of papulopustular rash induced by epidermal growth factor receptor inhibitors. These patients presented an unusual presentation of acneiform rash, characterized by late development (several months after treatment commenced), localization to the limbs with sparing of the face, and association with severe pruritus and Staphylococcus aureus superinfection in all cases. These clinical symptoms may suggest a distinct mechanism from the early acne-like rash frequently observed with these targeted anticancer therapies. Clinicians should be aware of this delayed adverse event, and we suggest the term 'late acneiform toxicity of EGFR inhibitors (LATE) syndrome' to permit better characterization of this clinical picture.
authors.affiliation: Dermatology, Oncology and Clinical Research Departments, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, France.
authors.forename: V
authors.initials: V
authors.lastname: Sibaud
authors.affiliation: Pathology Department, Institut Universitaire du Cancer, Toulouse Oncopole, France.
authors.forename: E
authors.initials: E
authors.lastname: Tournier
authors.affiliation: Oncology and Clinical Research Departments, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, France.
authors.forename: H
authors.initials: H
authors.lastname: Roché
authors.affiliation: Dermatology and Infectious Diseases Unit, Hopital Bonnet, CHI Fréjus Saint-Raphaël, Fréjus, France.
authors.forename: P
authors.initials: P
authors.lastname: Del Giudice
authors.affiliation: Oncology and Clinical Research Departments, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Delord
authors.affiliation: Dermatology and Infectious Diseases Unit, Hopital Bonnet, CHI Fréjus Saint-Raphaël, Fréjus, France.
authors.forename: T
authors.initials: T
authors.lastname: Hubiche
mesh_terms: D000328:Adult; D000368:Aged; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D000069347:Erlotinib Hydrochloride / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000009:adverse effects*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D011537:Pruritus / Q000139:chemically induced; D011799:Quinazolines / Q000009:adverse effects*; D017444:Skin Diseases, Papulosquamous / Q000139:chemically induced* / Q000382:microbiology / Q000473:pathology; D013203:Staphylococcal Infections / Q000209:etiology; D013211:Staphylococcus aureus / Q000302:isolation & purification
chemical_list: D010880:Piperidines; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors; C452423:vandetanib