PMC8220808_01
Timeline of disease status, corresponding treatments administered and development of skin toxicity.
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F1
A targeted therapy with erlotinib 150 mg daily was started and since the second cycle the patient experienced severe pruritus and developed a grade 2 cutaneous adverse event (AE), characterized by the appearance of an annular eruption involving the chest and upper arms (Figure 1). Based on this result, second line treatment with the third generation TKI osimertinib was initiated (Figure 1). Systemic therapy with prednisone 25 mg per day for 2 weeks was prescribed and skin lesions progressively improved (Figure 1).
(A) Cutaneous eruption composed of annular, palpable, pink, scaly plaques on the patient's upper chest, and arms. (B) Numerous erythematous annular plaques on the chest and arms with a typically photo distributed pattern.
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F2
Physical examination revealed numerous annular lesions, with raised pink borders and central clearing on the chest and upper arms (Figure 2A). Since the first cycle, the patient underwent a dramatic exacerbation of the itchy, erythematous and desquamating skin lesions, which involved the face and the chest (Figure 2B).