國家衛生研究院 NHRI:Item 3990099045/9163

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Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/9163

Title:	Clinicopathological study of epidermal growth factor receptor inhibitor-induced papulopustular lesions
Authors:	Hsu, CK;Yang, CC;Chang, KY;Falesa, T;Calonje, E;Lee, JYY
Contributors:	National Institute of Cancer Research
Abstract:	Several oncological drugs that target epidermal growth factor receptor (EGFR) have been developed over the last decade. For dermatologists, papulopustular or acneiform lesions are frequently seen in patients receiving EGFR inhibitors, including drugs such as cetuximab, geﬁtinib, erlotinib or afatinib, and development of a rash during therapy is thought to be an indicator of clinical responsiveness. Nevertheless, the dermatological manifestations can be somewhat variable and difﬁcult to treat. In this study, we describe the clinicopathological ﬁndings and therapeutic responses of papulopustular lesions in patients receiving EGFR inhibitors. We searched our department database for cases in which skin biopsy was performed for clinically diagnosed or suspected EGFR inhibitor-induced papulopustular eruptions. In total 22 patients were collected, including seven male and 15 female (age range 37 – 84 years, mean 61.5). Based on the clinical characteristics, the eruptions were classiﬁed into three groups: acne-like papulopustules affecting mainly the face and anterior chest (n = 5), purpuric vasculitis-like lesions with uniform purpuric pustules on the extremities and trunk (n = 9) and tinea capitis-like eruptions with follicular pustules or ulcers on the scalp (n = 8). The mean SD onset times for each subtype of eruption were 2.2 0.5, 18.6 6.3 and 10.5 2.3 weeks, respectively. The histopathology was characterized by suppurative and/or granulomatous folliculitis. Biopsies from acne-like papulopustules consisted mainly of dilated infundibula with intact pustules or very early ruptured follicles with focal granuloma formation. Purpuric vasculitis-like and tinea capitis-like lesions were often characterized by more superﬁcial and larger infun dibular or subcorneal pustules with or without focal mild acantholysis. The hair follicles appeared more extensively damaged than in the acne-like lesions. By bacterial cultures and Gram stain, staphylococcal infection was more commonly identiﬁed in the purpuric vasculitis-like and tinea capitis-like groups than in the acne-like group, and the latter lesions were less responsive to systemic antibiotics. In summary we have identiﬁed three patterns of EGFR inhibitor-induced papul opustular eruptions, and our study highlights the importance of skin biopsy and bacterial culture in evaluating these patients.
Date:	2015-07
Relation:	British Journal of Dermatology. 2015 Jul;173(Suppl. S1):73.
Link to:	http://dx.doi.org/10.1111/bjd.13761
JIF/Ranking 2023:	http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0007-0963&DestApp=IC2JCR
Cited Times(WOS):	https://www.webofscience.com/wos/woscc/full-record/WOS:000357729300149
Appears in Collections:	[Kwang-Yu Chang] Conference Papers/Meeting Abstract

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