A Linear And Reticulate Crusted Keratotic Papulopustular Eruption: A Rare Presentation Of PRIDE Complex

A 44-year-old male with squamous cell carcinoma of the head and neck developed a rare presentation of the PRIDE complex after 3 months of erlotinib treatment. The patient exhibited extensive red, crusted lesions with generalized itching, characterized by yellow keratotic papules and pustules arranged in linear and reticulate patterns on the chest, abdomen, shoulder, and back. Histopathology revealed dense neutrophilic infiltration and other skin changes. The condition, resembling keratosis lichenoides chronica (KLC), was managed successfully with 5% benzoyl peroxide, emollients, and antihistamines without discontinuing erlotinib. This case highlights an unusual presentation of PRIDE complex, typically associated with EGFR inhibitors, and underscores the importance of recognizing and managing such dermatological side effects in cancer patients.