A 73-year-old man with metastatic BRAF-mutant colorectal cancer presented with a 1-month history of crusted lesions with purulent drainage on the scalp, with associated pruritus and pain. Five months earlier he began treatment with cetuximab, binimetinib, and encorafenib, complicated by a grade 1 acneiform eruption that was managed with doxycycline hyclate and topical hydrocortisone and clindamycin phosphate. Oncologic therapy was withheld pending further evaluation of the scalp eruption. He had a distant history of actinic keratoses on the scalp treated with liquid nitrogen but otherwise denied previous skin cancer. Examination of the scalp revealed male pattern baldness, diffuse actinic damage, and multiple thick, yellow-brown crusts overlying erosions with purulent drainage (Figure 1). A wound culture was performed and grew methicillin-sensitive Staphylococcus aureus. A shave biopsy was obtained.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Joseph Zikry, MD, Department of Dermatology, Keck School of Medicine, University of Southern California, 1441 Eastlake Ave, Ezralow Tower, Ste 5301, Los Angeles, CA 90033 (firstname.lastname@example.org).
Published Online: November 12, 2020. doi:10.1001/jamaoncol.2020.5176
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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