Facial Papulopustular Eruption during the COVID-19 Pandemic in Patients Treated with EGFR Inhibitors
Table 1
Characteristics of the patients, type of cancer and oncologic treatment, PPR, use of mask, and previous adverse dermatological reactions.
Number of patients (percentage)
Sex
Female
19 (54.3%)
Male
16 (45.7%)
Primary cancer
NSCLC
16 (45.7%)
Breast cancer
1 (2.9%)
Gastrointestinal cancer
14 (40%)
HN SCC
4 (11.4%)
Anti-EGFR drug
Cetuximab
9 (25.7%)
Erlotinib
1 (2.9%)
Afatinib
7 (20.0%)
Osimertinib
2 (5.7%)
Gefitinib
7 (20.0%)
Panitumumab
8 (22.9%)
Others
1 (2.9%)
Combined therapy
BRAF inhibitors
1 (2.9%)
FOLFIRI
6 (17.1%)
PPR localization
Cheeks and chin
13 (37.1%)
All face
16 (45.7%)
Face and body
6 (17.1%)
Symptoms associated to the PPR
Puritus
28 (80%)
Xerosis
12 (34.3%)
Burning
30 (85.7%)
PPR MEST grading
Grade 1b
5 (14.3%)
Grade 2a
1 (2.9%)
Grade 2b
18 (51.4%)
Grade 3a
4 (11.4%)
Grade 3b
7 (20.0%)
PPR CTCAE grading
Grade 1
17 (20%)
Grade 2
21 (60%)
Grade 3
7 (20%)
Time to PPR since mask use
1 month
4 (11.4%)
2 months
7 (20%)
3 months
12 (34.3%)
4 months
6 (17.1%)
5 months
4 (11.4%)
6 months
2 (5.7%)
Topical treatment
High potency steroid cream
8 (22.9%)
Mild potency steroid cream
2 (5.7%)
Combo steroid + antiseptic/antibiotic cream
20 (57.1%)
Emollient cream
2 (5.7%)
Topical retinoids + steroids
3 (8.6%)
Systemic treatment
Antibiotics (doxycycline)
7 (20%)
Cutaneous outcome
Partial response
12 (34.3%)
Complete response
23 (65.7%)
Oncologic treatment
Modification
6 (17.1%)
Discontinuation
0 (0%)
Oncological treatment outcome
Partial response
24 (65.6%)
Complete response
6 (17.1%)
No response
5 (14.3%)
Previous PPR localization
Face and body
31 (88.6%)
Others
4 (11.4%)
Previous PPR MEST grading
Grade 1a
8 (22.9%)
Grade 1b
10 (28.6%)
Grade 2a
9 (25.7%)
Grade 2b
6 (17.1%)
Grade 3a
2 (5.7%)
Previous PPR CTACAE grading
Grade 1
18 (51.4%)
Grade 2
15 (42.9%)
Grade 3
2 (5.7%)
Other skin adverse event
Paronychia
5 (4.3%)
Pyogenic granuloma
1 (2.9%)
Trichomegaly
1 (2.9%)
Ungueal dystrophy
1 (2.9%)
Grade of other skin adverse events
Grade 1
8 (100%)
Personal history of dermatoses
None 35
35 (100%)
NSCLC: nonsmall-cell lung cancer. HN SCC: head and neck squamous cell carcinoma. EGFR: epidermal growth factor receptor. PRP: papulopustular reaction. FOLFIRI: folinic acid-fluorouracil-irinotecan regimen. MEST: Multinational Association for Supportive Care in Cancer (MASCC) EGFR inhibitor skin toxicity tool. CTCAE: National Cancer Institute: Common Terminology Criteria for Adverse Events.
