Cutaneous side-effects in patients on long-term treatment with epidermal growth factor receptor inhibitors.
BACKGROUND
Acute and subacute cutaneous side-effects of epidermal growth factor receptor inhibitors (EGFRIs) are very frequent and well known. Much less is known about the chronic cutaneous effects of these drugs and about their potential psychosocial impact on patients.


OBJECTIVE
We performed a retrospective study of patients treated with EGFRIs for more than 6 months.


METHODS
All patients had a detailed dermatological examination. The primary cancer, associated chemotherapies, skin treatment, evolution of skin symptoms and their impact on quality of life (QoL) as evaluated by the Dermatology Life Quality Index (DLQI) were noted.


RESULTS
Seven men and nine women were identified. The mean length of EGFRI treatment was 10 months (range 6-27). At the time of examination, all patients (100%) had cutaneous side-effects. Grade I or II folliculitis was found in 37.5% of the patients. Additional skin manifestations were xerosis (100%), mucositis (69%), hair abnormalities (87.5%), eyelash trichomegaly (62.5%), facial hypertrichosis (56%), painful paronychia (56%) and onycholysis (44%). Dose reduction or EGFRI discontinuation for skin toxicity were needed in six patients (37.5%). DLQI evaluation showed a moderate to strong impact on QoL in four patients (25%).


CONCLUSIONS
Cutaneous side-effects are found in 100% of patients treated with EGFRIs for more than 6 months and have a significant effect on patients' QoL. The clinical spectrum of skin manifestation varies over time. As the use of EGFRIs rapidly increases, it is critical for us to improve our knowledge in the understanding and managment of these skin manifestations.
Osio
A
A
Department of Dermatology, Institute Gustave Roussy, Villejuif, France.
Mateus
C
C
Soria
J-C
JC
Massard
C
C
Malka
D
D
Boige
V
V
Besse
B
B
Robert
C
C
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012871:Skin Diseases / Q000139:chemically induced*
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D066246:ErbB Receptors