[Skin eruptions as an adverse reaction to epidermal growth-factor receptor inhibitors].
Inhibition of the epidermal growth-factor receptor (EGFR) is a new strategy in the treatment of solid malignancies. Two men, aged 65 and 59 years, with a metastasized renal carcinoma and a 51-year-old man with a metastasized melanoma developed an acneiform eruption during EGFR inhibition. The second and third patient also developed paronychia. Treatment in all patients consisted of antiseptics and topical antibiotics; the first and third patient also received an oral antibiotic. Withdrawal of the EGFR inhibitor because of progression of the disease led to complete recovery of the cutaneous lesions in the first and the third patient; both died after several months. In the second patient, the side effects reached an acceptable level during continued EGFR therapy. EGFR inhibition is usually accompanied by cutaneous side effects. An acneiform eruption is seen in up to 90% of all treated patients. Other side effects include dry skin, and nail and hair changes. The pathogenesis of these side effects is related to inhibition of EGFR signalling pathways in the skin, but is not yet fully understood. The treatment of EGFR inhibitor-mediated cutaneous toxicity is based mainly on clinical experience.
Tjin-A-ton
M L R
ML
Universitair Medisch Centrum Utrecht, divisie Interne Geneeskunde en Dermatologie, Heidelberglaan 100, 3584 CX Utrecht.
van Montfrans
C
C
Koldenhof
J J
JJ
Sigurdsson
V
V
Voest
E E
EE
Witteveen
P O
PO
D017486:Acneiform Eruptions / Q000139:chemically induced*; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D002277:Carcinoma / Q000188:drug therapy; D000068818:Cetuximab; D003875:Drug Eruptions; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D000077156:Gefitinib; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy; D008297:Male; D008545:Melanoma / Q000188:drug therapy; D008875:Middle Aged; D010304:Paronychia / Q000139:chemically induced*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects; D011799:Quinazolines / Q000009:adverse effects
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D066246:ErbB Receptors; D000068818:Cetuximab; D000077156:Gefitinib