Hair Eruption Initiates and Commensal Skin Microbiota Aggravate Adverse Events of Anti-EGFR Therapy

Anti-EGFR therapy for cancer treatment was found to cause skin toxicities by disrupting EGFR/ERK signaling in LRIG1-positive stem cells, which are crucial for maintaining skin barrier integrity during hair eruption. This disruption allowed commensal skin microbiota to invade hair follicles, leading to inflammatory skin diseases with TH2, TH1, and TH17 immune responses, resulting in chronic folliculitis. The study suggested that restoring ERK signaling through FGF7 treatment or transgenic SOS expression could mitigate these adverse effects by repairing the barrier defect, offering a potential therapeutic approach to manage these skin toxicities.