Erosive Pustular Dermatosis of the Scalp Due to Afatinib: A Rare Case

Abstract

Afatinib is a tyrosine kinase inhibitor that irreversibly targets the epidermal growth factor receptor and is commonly associated with cutaneous adverse effects such as acneiform eruptions and paronychia. However, scalp involvement has rarely been reported. We present a case of a 57-year-old woman with stage IVA lung cancer who developed thick, yellowish scalp crusts without pain or itch, seven months after initiating afatinib therapy. Clinical, trichoscopic, microbiological, and histopathological examinations confirmed a diagnosis of erosive pustular dermatosis of the scalp (EPDS). Despite treatment with systemic corticosteroids and antibio-tics, significant improvement was only observed after dose reduction and eventual discontinuation of afatinib. This case highlights a rare but important adverse effect of afatinib on the scalp, emphasizing the need for clinicians to recognize and manage EPDS early in patients receiving this therapy.