Grade 3 or 4 acne-like rash ( in 209 of 785 patients [ 27 % ] vs four of 805 [ < 1 % ] ) , diarrhoea ( 113 [ 14 % ] vs 70 [ 9 % ] ) , mucositis ( 63 [ 8 % ] vs 10 [ 1 % ] ) , and infusion-related reactions ( 55 [ 7 % ] vs 30 [ 4 % ] ) were more frequent in patients treated with FOLFOX4 plus cetuximab than in those patients who received FOLFOX4 alone .