Scalp Pustule as a Manifestation of Erlotinib-Induced Skin Toxicity: Report of Two Cases and Literature Review

This study reports two cases of erlotinib-induced erosive pustular dermatosis of the scalp (EPDS), highlighting a rare skin toxicity associated with epidermal growth factor receptor inhibitors (EGFRIs) used in cancer treatment. A 73-year-old female and a 37-year-old male both experienced scalp pustules and alopecia, with significant neutrophilic infiltration and increased EGFR expression in scalp tissue. The findings suggest that EGFR inhibition disrupts keratinocyte function, triggering inflammatory responses and follicular damage. The study underscores the importance of early detection and management of EGFRI-related skin toxicities, recommending antibiotics and topical steroids, and calls for further research to improve treatment strategies.