The Double-Edged Sword of Epidermal Growth Factor Receptor Inhibitor: Rash as Toxicity and Prognostic Marker

A 50-year-old man receiving epidermal growth factor receptor inhibitor (EGFRI) lapatinib 1250 mg/day after a bilateral mastectomy for stage 2 breast carcinoma, presented with itchy and dry skin for 15 days.Examination showed papulopustular lesions over the chest and the entire back with tender pustules measuring 0.5-1 mm in diameter [Figure 1a and b] with no crusting.Comedones were absent.Diagnosis was made based on clinical findings.No investigations were performed due to the characteristic presentation and no signs of secondary infection.e patient was counseled on the benign nature of the condition and the importance of not discontinuing the treatment to be provided, started on tablet doxycycline 100 mg and topical hydrocortisone cream.At 1-week follow-up, the patient showed significant improvement [Figure 2a andb].Papulopustular rash, also termed acneiform eruption, is the most frequent cutaneous adverse effect of EGFRIs, reported in 50-100% of patients. [1]is is part of the 'PRIDE' complex, which encompasses multiple cutaneous adverse effects linked to EGFRI therapy, including acneiform eruptions, xerosis, eczema, paronychia, and hair and nail changes. [2]It often affects seborrheic areas