By Gary M. White, MD

EPPER: Eosinophilic, Polymorphic, and Pruritic Eruption associated with Radiotherapy

This patient developed an eczematous rash on the upper chest in the general area of radiation therapy for throat cancer performed 7 months prior.

EPPER is an intense, polymorphic and pruritic eruption occurring after radiotherapy. EPPER stands for Eosinophilic, Polymorphic, and Pruritic Eruption associated with Radiotherapy.


A localized or generalized pruritic rash with composed of erythematous papules and plaques is seen. Occasionally, there may be pustules and/or vesicobulla.


Antihistamines, topical corticosteroids or oral corticosteroids as well as ultraviolet B therapy may be helpful. Spontaneous resolution may occur.


EPPER 2 days after the completion of the radiotherapy of the right breast. JAAD February 2007;56, Issue 2, Supplement, Pages S60–S61

A pustular form of EPPER of the scalp 2 days into radiation therapy for a brain tumor. JAAD 2011;65, Issue 2, Pages e51–e53


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