Erlotinib inhibits the tyrosine kinase of epidermal growth factor receptor (EGFR) and is successfully used in lung cancer treatment. EGFR is essential in skin development and function and may have a role in the pathogenesis of psoriasis. Cutaneous side effects are very common in patients treated with erlotinib, and therapeutic use of erlotinib in dermatological disorders has therefore not been considered. We report two cases of patients with lung cancer and concomitant psoriasis treated with erlotinib with complete resolution of the skin problems. We present a review of the current literature on the topic.

1.
King LE Jr, Gates RE, Stoscheck CM, Nanney LB: The EGF/TGF alpha receptor in skin. J Invest Dermatol 1990;94(6 suppl):164S–170S.
2.
Nanney LB, Stoscheck CM, Magid M, King LE Jr: Altered [125I]epidermal growth factor binding and receptor distribution in psoriasis. J Invest Dermatol 1986;86:260–265.
3.
Ben Bassat H: Biological activity of tyrosine kinase inhibitors: novel agents for psoriasis therapy. Curr Opin Investig Drugs 2001;2:1539–1545.
4.
Trivin F, Boucher E, Raoul JL: Complete sustained regression of extensive psoriasis with cetuximab combination chemotherapy. Acta Oncol 2004;43:592–593.
5.
van Ruissen F, de Jongh GJ, van Erp PE, Boezeman JB, Schalkwijk J: Cell kinetic characterization of cultured human keratinocytes from normal and psoriatic individuals. J Cell Physiol 1996;168:684–694.
6.
King LE Jr, Gates RE, Stoscheck CM, Nanney LB: Epidermal growth factor/transforming growth factor alpha receptors and psoriasis. J Invest Dermatol 1990;95:10S–12S.
7.
Ben Bassat H, Levitzki A: Inhibitors of tyrosine kinases in the treatment of psoriasis. Isr Med Assoc J 2000;2(suppl):69–73.
8.
Mermelstein FH, Abidi TF, Laskin JD: Inhibition of epidermal growth factor receptor tyrosine kinase activity in A431 human epidermoid cells following psoralen/ultraviolet light treatment. Mol Pharmacol 1989;36:848–855.
9.
Powell TJ, Ben Bassat H, Klein BY, et al: Growth inhibition of psoriatic keratinocytes by quinazoline tyrosine kinase inhibitors. Br J Dermatol 1999;141:802–810.
10.
Varani J, Kang S, Stoll S, Elder JT: Human psoriatic skin in organ culture: comparison with normal skin exposed to exogenous growth factors and effects of an antibody to the EGF receptor. Pathobiology 1998;66:253–259.
11.
Zorzou MP, Stratigos A, Efstathiou E, Bamias A: Exacerbation of psoriasis after treatment with an EGFR tyrosine kinase inhibitor. Acta Derm Venereol 2004;84:308–309.
12.
Giroux LE, Friard S, Couderc LJ: Improvement of psoriasis in a lung cancer patient treated with erlotinib. Eur J Dermatol 2010;20:243–244.
13.
Narayanan S, Callis-Duffin K, Batten J, Agarwal N: Improvement of psoriasis during sunitinib therapy for renal cell carcinoma. Am J Med Sci 2010;339:580–581.
14.
Keshtgarpour M, Dudek AZ: SU-011248, a vascular endothelial growth factor receptor-tyrosine kinase inhibitor, controls chronic psoriasis. Transl Res 2007;149:103–106.
15.
Fournier C, Tisman G: Sorafenib-associated remission of psoriasis in hypernephroma: case report. Dermatol Online J 2010;16:17.
16.
Halin C, Fahrngruber H, Meingassner JG, et al: Inhibition of chronic and acute skin inflammation by treatment with a vascular endothelial growth factor receptor tyrosine kinase inhibitor. Am J Pathol 2008;173:265–277.
17.
Wierzbicka E, Tourani JM, Guillet G: Improvement of psoriasis and cutaneous side-effects during tyrosine kinase inhibitor therapy for renal metastatic adenocarcinoma. A role for epidermal growth factor receptor (EGFR) inhibitors in psoriasis? Br J Dermatol 2006;155:213–214.
18.
Miyagawa S, Fujimoto H, Ko S, Hirota S, Kitamura Y: Improvement of psoriasis during imatinib therapy in a patient with a metastatic gastrointestinal stromal tumour. Br J Dermatol 2002;147:406–407.
19.
Wrone-Smith T, Nickoloff BJ: Dermal Injection of immunocytes induces psoriasis. J Clin Invest 1996;98:1878–1887.
20.
Mascia F, Mariani V, Girolomoni G, Pastore S: Blockade of the EGF receptor induces a deranged chemokine expression in keratinocytes leading to enhanced skin inflammation. Am J Pathol 2003;163:303–312.
21.
Khetarpal VK, Markham PM, Ziemniak JA: Dispositional characteristics of a tyrosine kinase inhibitor (RG 14620) in rats and rabbits following intravenous administration or dermal application. Drug Metab Dispos 1994;22:216–223.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.