A 63-year-old man with Olmsted syndrome, a rare genetic condition, experienced intense pain and severe impact on his quality of life. Genetic testing confirmed a TRPV3 mutation, and treatment with erlotinib led to a dramatic improvement in pain within 24 hours. The patient's condition significantly improved over three months with erlotinib, highlighting its effectiveness in treating Olmsted syndrome. This case adds to the evidence supporting erlotinib as a potential treatment option for this condition.