# A client on cetuximab develops an acneiform rash on the face and upper chest. Which is the nurse's most appropriate response?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391870&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A client on cetuximab develops an acneiform rash on the face and upper chest. Which is the nurse's most appropriate response?

## Option

1. Continue therapy with skin care (gentle cleansing, sunscreen, topical antibiotics or corticosteroids per protocol); rash often correlates with better tumor response **✔ Correct answer**
2. Discontinue all therapy permanently
3. Apply hydrocortisone and ignore
4. Switch to immunotherapy immediately

**Correct answer: 1**

## Explanation

Correct (2): Cetuximab/panitumumab (anti-EGFR) cause acneiform rash in ~80%. Counterintuitively, rash often correlates with treatment response. Manage with skin care, sunscreen, topical antibiotics (clindamycin) or steroids, oral tetracyclines (doxycycline) for severe rash; dose reduction only if grade ≥3. (1) Premature. (3) Inadequate. (4) Inappropriate.

## In-depth explanation

Memory Tip Anti-EGFR (Cetuximab·Panitumumab) = "Rash means RESPONSE." Hypomagnesemia common — monitor Mg. KRAS wild-type required for efficacy.

## Clinical scenario

Scenario 55-year-old male on cetuximab for metastatic colorectal cancer; develops papulopustular rash on face/chest at week 2.

## Key concepts

- **Anti-EGFR antibody** — Cetuximab, panitumumab; for KRAS WT colorectal and H&N cancer.
- **Acneiform rash** — EGFR pathway inhibition → folliculitis-like rash; biomarker of response.
- **Hypomagnesemia from EGFR** — Wasting nephropathy from EGFR blockade; check Mg routinely.

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