Clinical management of cutaneous toxicity of anti-EGFR agents.
Cutaneous toxicity is the most evident adverse effect of epidermal growth factor receptor (EGFR) inhibitors because of the specific role played by EGFR in skin biophysiology. Dermatological adverse reactions, mainly folliculocentric, have been widely reported in the literature. However, the mechanism of these reactions is not well defined and their management is still a matter of debate. In this paper keratinocyte differentiation, activation and pathways regulating gene expression are reviewed in order to improve the understanding of adverse skin reactions and obtain success in their management. The authors had the opportunity to treat skin reactions induced by cetuximab in a cohort of patients affected by metastatic colorectal carcinoma. The aims of this clinical approach were to control the signs and symptoms of skin toxicity in order to avoid delay in cancer therapy and to use nondrug agents for the treatment of drug-induced skin reactions.
Monti
M
M
Department of Dermatology, University of Milan and Clinical Institute Humanitas, Milan, Italy. marcello.monti@humanitas.it
Motta
S
S
D000911:Antibodies, Monoclonal / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D001557:Benzenesulfonates; D002454:Cell Differentiation; D000068818:Cetuximab; D000075202:Contraindications; D003875:Drug Eruptions / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D005076:Exanthema / Q000139:chemically induced; D017789:Granuloma, Pyogenic / Q000139:chemically induced / Q000628:therapy; D006201:Hair Diseases / Q000139:chemically induced / Q000628:therapy; D006801:Humans; D015603:Keratinocytes / Q000187:drug effects; D010304:Paronychia / Q000139:chemically induced / Q000628:therapy; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D012459:Salicylates / Q000627:therapeutic use; D012871:Skin Diseases / Q000139:chemically induced / Q000628:therapy; D014212:Tretinoin
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001557:Benzenesulfonates; D047428:Protein Kinase Inhibitors; D012459:Salicylates; D014212:Tretinoin; D066246:ErbB Receptors; C003366:sulfosalicylic acid; D000068818:Cetuximab