Cutaneous reactions to chemotherapy and their management Journal Article


Authors: Wyatt, A. J.; Leonard, G. D.; Sachs, D. L.
Article Title: Cutaneous reactions to chemotherapy and their management
Abstract: International data from 2002 report 10.9 million new cases of cancer and 6.7 million cancer deaths. Chemotherapy is an essential component in the multidisciplinary management of most cancers. Cutaneous reactions to chemotherapeutics are common and may contribute significantly to the morbidity, and rarely to the mortality, of patients undergoing such treatments. Recognition and management of these reactions is important to provide optimal care. This article aims to present the most common cutaneous reactions to frequently used chemotherapies and provides management guidelines. A MEDLINE search from 1966 through June 2005 was conducted to identify reports of common cutaneous toxicities with systemic chemotherapy and their appropriate management. An analysis of our literature search is presented in review form outlining common chemotherapy-related cutaneous reactions and their management, as well as the chemotherapeutics responsible for the cutaneous toxicity. Chemotherapy-related cutaneous toxicity includes generalized rashes such as the spectrum between erythema multiforme and toxic epidermal necrolysis, and site-specific toxicity such as mucositis, alopecia, nail changes, extravasation reactions, or hand-foot syndrome. Most of the toxicity is reversible with chemotherapy dose reductions or delays. Certain toxicities can be effectively treated or prevented, allowing optimal delivery of chemotherapy (e.g. premedications to prevent hypersensitivity, prophylactic mouthwashes to prevent mucositis). Newer non-chemotherapeutic targeted therapies such as epidermal growth factor receptor inhibitors (e.g. gefitinib, cetuximab) may also be associated with cutaneous toxicity and can be distressing for patients. Recent data suggest that skin toxicity associated with these agents may correlate with efficacy. Cutaneous toxicity occurs frequently with chemotherapy and non-chemotherapeutic biologic therapies. Early recognition and treatment of the toxicity facilitates good symptom control, prevents treatment-related morbidity, and allows continuation of anti-cancer therapy. © 2006 Adis Data Information BV. All rights reserved.
Keywords: cancer chemotherapy; hydroxyurea; clinical trial; review; squamous cell carcinoma; cisplatin; erlotinib; fluorouracil; ascites; diarrhea; dose response; drug dose reduction; drug efficacy; nonhuman; side effect; skin toxicity; antineoplastic agents; skin manifestation; cytarabine; drug megadose; antineoplastic agent; neoplasms; colorectal cancer; unindexed drug; edema; metastasis; drug eruption; breast cancer; actinic keratosis; etoposide; blood toxicity; mucosa inflammation; nausea; stomatitis; drug administration schedule; morbidity; skin cancer; practice guideline; radiation injury; cetuximab; psoriasis; cancer mortality; vinblastine; irinotecan; drug hypersensitivity; flushing; nail disease; prostate cancer; rash; chemotherapy induced emesis; correlation analysis; dimethyl sulfoxide; hematologic malignancy; nonsteroid antiinflammatory agent; cardiotoxicity; acne; gefitinib; peripheral edema; dactinomycin; erythema; hyperpigmentation; hair disease; lichen planus; bleomycin; medline; pleura effusion; antihypertensive agent; dermatomyositis; papule; vinca alkaloid; symptomatology; taxane derivative; corticosteroid; toxicity; disease control; autoimmune disease; calcineurin inhibitor; hand foot syndrome; tetracycline; pericardial effusion; alopecia; anaphylaxis; gynecomastia; mouth carcinoma; leg edema; skin necrosis; retinoid; urticaria; skin ulcer; epidermal growth factor receptor kinase inhibitor; fluid retention; raynaud phenomenon; drug eruptions; angioneurotic edema; paronychia; skin allergy; stevens johnson syndrome; toxic epidermal necrolysis; xerosis; measles like rash; skin atrophy; sore throat; premedication; mouthwash; palifermin; delayed hypersensitivity; arteritis; mouth ulcer; nose ulcer; onycholysis; trichomegaly; abscess; vein embolism; eosinophilia; erythema multiforme; skin fibrosis; vasculitis; leg ulcer; petrolatum; extravasation; pyridoxine; bullous skin disease; hidradenitis; melanonychia; photoallergy; scleroderma; folliculitis; oral mucosal disease; condyloma acuminatum; vesicular rash; xipamide; anthracycline antibiotic agent; antidote; imuvert; podophyllin; artery embolism; darier disease; intertrigo; kinky hair; lupus erythematosus; pemphigus; verruca plantaris
Journal Title: American Journal of Clinical Dermatology
Volume: 7
Issue: 1
ISSN: 1175-0561
Publisher: Adis International Ltd  
Date Published: 2006-01-01
Start Page: 45
End Page: 63
Language: English
DOI: 10.2165/00128071-200607010-00005
PUBMED: 16489842
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 28" - "Export Date: 4 June 2012" - "CODEN: AJCDC" - "Source: Scopus"
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MSK Authors
  1. Gregory David Leonard
    15 Leonard
  2. Dana L Sachs
    23 Sachs