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Diagnosing cutaneous cytomegalovirus (CMV) is difficult due to its rarity and diverse manifestations, and early recognition is crucial as it may indicate disseminated disease and a poor prognosis. We examined a 71-year-old Taiwanese male presenting with a 1-week history of progressive, painful papulopustules associated with superficial ulcers and thick yellowish crusts on the scalp. He had been diagnosed with stage IVb lung adenocarcinoma 6 weeks earlier, and the epidermal growth factor receptor inhibitor (EGFRI) erlotinib and radiothe