Histopathologic features of erythematous papulopustular eruption to epidermal growth factor receptor inhibitors in cancer patients.

J Cutan Pathol. 2015 Oct 1. doi: 10.1111/cup.12630. [Epub ahead of print]
Histopathologic features of erythematous papulopustular eruption to epidermal growth factor receptor inhibitors in cancer patients.
Bellini V1, Bianchi L1, Pelliccia S1, Lisi P1.

BACKGROUND:
Erythematous papulopustular eruption (EPPE) is the most frequent skin adverse event to epidermal growth factor receptor (EGFR) inhibitors but its histopathologic features have been poorly studied. As EPPE is a strong predictor of patient's treatment response, the EPPE histopathologic features and their correlations with skin eruption severity and involved drug were investigated.
METHOD:
An involved skin biopsy was carried out in 39 informed patients treated with EGFR inhibitors (mainly cetuximab and erlotinib). The cutaneous changes in hematoxylin-eosin stained sections were evaluated.
RESULTS:
The EPPE to EGFR inhibitors is histopathologically characterized by neutrophilic subcorneal or intraepidermal pustules and polymorphous infiltrate of the superficial dermis during the earliest phases and by lymphocytic perifolliculitis and/or suppurative folliculitis at a later phase. The widespread dermis inflammation was more frequent in severe EPPEs and in patients treated with cetuximab, while the hair follicle inflammation was observed only in mild/moderate EPPEs.
CONCLUSION:
Our study shows the histopathologic signs of EPPE and their correlation with clinical severity and the offending drug.
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KEYWORDS:
epidermal growth factor receptor inhibitors; erithematous papulopustular eruption; histopathology; side effects; skin toxicity

I've dealt with some who have taken EGFR inhibitors (along with their former cancer 'treatments'), the outcome was the forms of severe type conditions listed above.