Atlas of dermatopathology: Folliculitis caused by EGFR inhibitors therapy

+ Introduction

+ Literature

+ Support

+ Skin biopsy

+ Non-tumorous skin diseases

+ Skin tumors

+ Mesenchymal tumors

+ Cysts of the skin and subcutis

+ Soft tissue lesions

+ Some lesions of the oral cavity

+ Dermatovenerology

+ Collection of histological slides by prof. Günter Burg

+ Collection of histological slides by prof. Werner Kempf

+ Collection of histological slides of dr. Ram Chandra Adhikari

Folliculitis caused by EGFR inhibitors therapy

Introduction

EGFR (epidermal growth factor receptor) is a cell surface receptor, whose mutations (overexpression) are associated with cancerogenesis. EGFR inhibitors are used in therapy of various tumors, namely carcinomas of the lung and colon. Testing for EGFR overexpression is important to estimate the outcome of EGFR inhibitors therapy.

Etiology

Purulent folliculitis is an obligatory side effect of the therapy (present in more than two thirds of patients) and may be a marker for tumor response.

papules and pustules: purulent folliculitis
usual distribution: face, neck, upper trunk
may disappear even when the therapy continues
paronychial inflammation (6% of patients): tender, edematous nail folds may change into ulcerations with granulation tissue
xerosis cutis, frontal alopecia

Pictures

Papulopustular exanthema, EGFR inhibitors: Drug reaction, EGFR, papulopustulous, Clinical picture (6344) Drug reaction, EGFR, papulopustulous, Clinical picture (6345) Drug reaction, EGFR, pustulous, Clinical picture (6346) Drug reaction, EGFR, papulopustulous, Clinical picture (6352)

Paronychia, EGFR inhibitors: Drug reaction, EGFR, paronychia, Clinical picture (6353)

Trichomegaly, EGFR inhibitors: Drug reaction, EGFR, trichomegaly, Clinical picture (6354)

Xerosis cutis, EGFR inhibitors: Drug reaction, EGFR, xerosis cutis, Clinical picture (6355)

Impetigo, EGFR inhibitors dermatitis: Drug reaction, EGFR, impetiginized, Clinical picture (6359)

Histology

Perifollicular T lymphocytic infiltrate, neutrophilic infiltrate, sterile, especially at infundibular area. No comedones are formed, sebaceous glands are spared.

Pictures

EGFR inhibitors therapy, folliculitis: Purulent folliculitis, anti-EGFR therapy, HE 60x (6400)

Another case: Folliculitis purulent, EGFR, HE 60x (6317)

Another case, with granulomatous reaction: Folliculitis purulent, EGFR, HE 60x (6319) Folliculitis purulent, EGFR, HE 60x (6318)

Another case: Folliculitis purulent, EGFR, HE 60x (6320)

Another case: Folliculitis purulent, EGFR, HE 60x (6321)

Another case: Folliculitis purulent, EGFR, HE 60x (6322)

Another case, slight epidermal changes in xerosis cutis, superficial epidermal defect: Drug reaction, EGFR, HE 60x (6332) Drug reaction, EGFR, HE 60x (6331) Drug reaction, EGFR, HE 60x (6333) Drug reaction, EGFR, HE 60x (6334)

Another case of folliculitis: Drug reaction, EGFR inhibitors therapy, HE 60x (10028) Drug reaction, EGFR inhibitors therapy, HE 60x (10029)

EGFR inhibitor therapy, folliculitis, Tarceva: Folliculitis purulent, Tarceva, HE 60x (10068)

EGFR inhibitor therapy, folliculitis, Tarceva: Folliculitis, Tarceva therapy, HE 60x (10170) Folliculitis, Tarceva therapy, PAS 60x (10171) Folliculitis, Tarceva therapy, Gram 60x (10169)