Management of dermatologic adverse events from cancer therapies: recommendations of an expert panel

Jade Cury-Martins, Adriana Pessoa Mendes Eris, Cristina Martinez Zugaib Abdalla, Giselle de Barros Silva, Veronica Paula Torel de Moura, Jose Antonio Sanches, Jade Cury-Martins, Adriana Pessoa Mendes Eris, Cristina Martinez Zugaib Abdalla, Giselle de Barros Silva, Veronica Paula Torel de Moura, Jose Antonio Sanches

Abstract

With the development of new cancer therapies, systemic toxicity profile and effects on survival achieved an important improvement. However, a constellation of toxicities has emerged, even more remarkably, cutaneous adverse events. This report, developed by a board of Brazilian experts in oncodermatology, aims to establish a guideline for the dermatological care of oncologic patients. When possible, evidence-based recommendations were made, but in many cases, when strong evidence was not available, a consensus was reached, based on some data supporting therapies combined with personal experiences.

Keywords: Antineoplastic agents; Antineoplastic agents, immunological; Dermatology; Drug-related side effects and adverse reactions; Medical oncology; Molecular targeted therapy.

Copyright © 2020 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.

Figures

Figure 1
Figure 1
Different hyperpigmentation patterns: (A) serpentine supravenous hyperpigmentation after peripheral chemotherapy infusion (fluorouracil); (B) nail plate pigmentation (daunorubicin); (C) acral lentiginoses (doxorubicin).
Figure 2
Figure 2
Flagellate dermatitis associated to bleomycin treatment: (A) pruritic erythematous linear streaks, (B) followed by linear pigmentation.
Figure 3
Figure 3
PATEO syndrome (PeriArticular Thenar Erythema and Onycholysis): docetaxel treated patient presenting with (A) erythematous lesions with a distinct distribution to the dorsal aspects of the hands and (B) associated nail changes – subungual hemorrhage and onycholysis.
Figure 4
Figure 4
EGFR inhibitors related adverse events: (A and B) inflammatory papulopustular rash with associated xerosis (*); (C) trychomegaly and hypertrichosis; (D) periungual fissures and (E) pyogenic granuloma-like lesions. (A, B, D and E on cetuximab treated patients; C on panitumumab treated patient).
Figure 5
Figure 5
Toxic erythema of chemotherapy (TEC): combination of different lesions caused by direct toxicity of chemotherapy agents with (A) lesions on flexural areas (intertriginous eruption associated with chemotherapy) and (B) on palms and soles (Hand-foot syndrome – HFS).
Figure 6
Figure 6
Hand-foot skin reaction (HFSR) associated with antiangiogenic agents (VEGFRi): (A) hyperkeratotic lesions (sorafenib) and (B) bullous lesions (axitinib) on areas of pressure and friction.
Figure 7
Figure 7
BRAF inhibitor related adverse events: multiple keratoachantomas (A) and low grade squamous cell carcinomas (B) after withdrawal of MEK inhibitor and maintenance of BRAF inhibitor; (C) associated keratosis pilaris-like eruption on the lower limbs.

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Source: PubMed

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