Erosive Pustular Dermatosis of the Scalp-Like Eruption Due to Gefitinib: Case Report and Review of Alopecia Associated with EGFR Inhibitors

A 69-year-old Japanese woman with non-small-cell lung cancer developed erythematous erosive alopecia with pustules on the scalp after three years of gefitinib treatment. A biopsy revealed dense perifollicular infiltration, and methicillin-resistant Staphylococcus aureus was cultured from the lesions, but antibiotics were ineffective. The condition, resembling erosive pustular dermatosis of the scalp, improved rapidly after discontinuing gefitinib. Including this case, there were 11 reported cases of alopecia associated with EGFR inhibitors, all in females, primarily affecting the parietal scalp, and requiring reduction or discontinuation of the inhibitors, resulting in scarring alopecia.