Scalp Eruption in a Patient With Metastatic Colon Cancer

Egfri-Induced Skin Folliculitis Presenting on the Scalp: A Case Report

“…Epidermal growth factor receptor inhibitors (EGFRIs) are a group of anticancer agents approved for the therapeutic use on a wide array of solid tumors including, but not limited to, colorectal, nonsmall cell lung, and ovarian cancer [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. EGFRs are commonly expressed in cancer cells, but can also be found in epidermal keratinocytes and sebocytes.…”

“…Upon activation, EGFRs initiate a signaling cascade, promoting the uncontrolled cell division and proliferation of cancer cells. Consequently, EGFRIs prevent the signal transduction of such receptors, thereby impeding the growth of solid tumors [1,2,[4][5][6][7][11][12][13][14][15]. EGFRI therapy is known to cause mild to severe skin eruptions in upwards of 90% of patients [14].…”

“…The erythematous folliculitis that develops is often used by oncologists as an indicator of the agent's efficacy, with patients who respond best to therapy developing the most severe folliculitis [1, 2, 4, 6, 8-11, 13, 15]. The drug-induced folliculitis is most commonly present on a patient's upper body, face, and proximal arms [4,6,8,15]. The case we present below is notable due to the severity of the folliculitis, which presented on the scalp of an otherwise stable patient Management of the resulting skin toxicity is initiated once symptoms are apparent.…”

“…Depending on the severity of the condition, some patients may decide to discontinue chemotherapy altogether. For this reason, better preemptive skin regimens can help reduce the severity of EGFRI-induced acneiform rash, all-the-while allowing patients to benefit from the agent's antineoplastic properties [6,8,9,[11][12][13][14][15].…”