title: Management of skin toxicities of anti-EGFR agents in patients with pancreatic cancer and other GI tumors by using electronic communication: effective and convenient.
abstract: Erlotinib has been FDA approved to be used in combination with gemcitabine as the first line treatment in advanced pancreatic cancer patients. Skin rash has been documented as one of the commonest adverse reactions in patients receiving erlotinib and other EGFR inhibitors. Draw back to this reaction leads to: 1) drug discontinuation or dose reduction; 2) impairs quality of life; and 3) Puts patients at risk of superinfection. Monitoring patients closely and initiating immediate skin care is recommended. However, patients forget how the rash started and when. No standard treatments exist secondary to the diversity of symptoms, variability and intermittent occurrence in relation to the cancer therapy. In addition, there is slow improvement with medical treatment. Also, patients need to make extra visits to doctor's office for skin management when in needed in addition to chemotherapy appointments. Late presentation for medical attention leading to complications, such as sepsis. We here experience a novel way of assessing and managing the skin rash using the electronic media. We suggest that electronic communication is of crucial importance to detect early, diagnose and treat anti-EGFR related skin rash in order to continue the benefit of anti-EGFR.
authors.affiliation: Section of Medical Oncology, Yale University School of Medicine, New Haven, CT 06520, USA. wasif.saif@yale.edu
authors.forename: Muhammad Wasif
authors.initials: MW
authors.lastname: Saif
authors.forename: Kristin
authors.initials: K
authors.lastname: Kaley
authors.forename: Lynne
authors.initials: L
authors.lastname: Lamb
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pecerillo
authors.forename: Susan
authors.initials: S
authors.lastname: Hotchkiss
authors.forename: Lisa
authors.initials: L
authors.lastname: Steven
authors.forename: Marianne
authors.initials: M
authors.lastname: Brennan
authors.forename: Robin
authors.initials: R
authors.lastname: Penney
authors.forename: Carolyn
authors.initials: C
authors.lastname: Gillespie
authors.forename: Walid
authors.initials: W
authors.lastname: Shaib
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D000465:Algorithms; D001296:Audiovisual Aids; D002277:Carcinoma / Q000188:drug therapy*; D003142:Communication; D003266:Continuity of Patient Care; D064420:Drug-Related Side Effects and Adverse Reactions / Q000628:therapy; D004526:Efficiency; D034742:Electronic Mail; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D006297:Health Services Accessibility; D006801:Humans; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D010349:Patient Compliance; D010817:Physician-Patient Relations; D047428:Protein Kinase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012871:Skin Diseases / Q000139:chemically induced* / Q000628:therapy*; D013685:Telecommunications
chemical_list: D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors