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BACKGROUND
A 69-year-old woman with metastatic clear-cell renal cell carcinoma (RCC) presents with a maculopustular, acne-like rash on her scalp, face, and posterior aspect of her trunk. The rash has lasted 9 days. The patient's history is significant for treatment with erlotinib, an epidermal growth factor inhibitor, which was started approximately 2 weeks ago to treat persistent growth of a metastatic lesion in her pancreas despite therapy with bevacizumab, a vascular endothelial factor inhibitor. Surgical resection for kidney cancer was attempted several years ago.
Over the past few days, the rash has become pustular with notable crusting. Treatment with a topical antibiotic cream and an oral antibiotic has proved ineffective. The rash has spread to the back and is now involving an increasing area of the scalp (see Images).
What is the diagnosis? |
Hint
A drug-induced condition. |
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Authors:
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Joyce M. Siler, RN,
Oncology Nurse,
Mayo Clinic,
Jacksonville, Fla
Winston W. Tan, MD, FACP,
Assistant Professor of Medicine,
Division of Hematology/Oncology,
Mayo Clinic College of Medicine,
Jacksonville, Fla
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eMedicine
Editor:
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Rick G. Kulkarni, MD,
Assistant Professor,
Yale School of Medicine,
Section of Emergency Medicine,
Department of Surgery,
Attending Physician,
Medical Director,
Department of Emergency Services,
Yale-New Haven Hospital, Conn
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