title: Impact of dermatologic adverse events on quality of life in 283 cancer patients: a questionnaire study in a dermatology referral clinic.
abstract: BACKGROUND
  Anticancer therapies cause a wide range of dermatologic adverse events (AE). Although the frequency and severity of these events have been described, their effects on health-related quality of life (QoL) remain poorly understood, and the ones having a greater impact have not been ascertained.
  
  
  OBJECTIVE
  To assess QoL in patients on conventional versus targeted anti-cancer therapies using a dermatology-specific questionnaire.
  
  
  METHODS
  Patients (n = 283) completed the Skindex-16, a QoL questionnaire measuring the effects on three domains: symptoms, emotions, and function. Patients were grouped into two categories according to the types of oncology treatments received: (1) targeted therapies and (2) non-targeted therapies. Correlations of Skindex-16 scores with type of anti-cancer therapy, number of AEs, and specific dermatologic AEs were investigated.
  
  
  RESULTS
  Significant differences between patients treated with targeted versus non-targeted therapy with regards to total Skindex-16 (p = 0.02) and emotion subdomain (p = 0.02) scores were observed. Additionally, patients on targeted therapies experienced a significantly greater number of AEs (p < 0.001) compared with patients on non-targeted therapies. Patients who exhibited epidermal growth factor receptor (EGFR) inhibitor-induced rash had higher Skindex-16 scores (p = 0.009) and higher scores in the symptom (p < 0.001), emotion (p = 0.01), and function (p = 0.001) subdomains than patients without this AE. Similar results were observed for pruritus. All p values were two sided.
  
  
  CONCLUSIONS
  Dermatologic AEs are associated with a diminished QoL. Targeted therapies are associated with a significantly increased number of AEs and worse total and emotion Skindex-16 scores in comparison with non-targeted therapies. EGFR inhibitor rash and pruritus produced the greatest negative impact.
authors.affiliation: Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Rockefeller Outpatient Pavilion Suite 228, 160 East 53rd St, New York, NY 10022, USA.
authors.forename: Alyx C
authors.initials: AC
authors.lastname: Rosen
authors.forename: Emily C
authors.initials: EC
authors.lastname: Case
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Dusza
authors.forename: Yevgeniy
authors.initials: Y
authors.lastname: Balagula
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gordon
authors.forename: Dennis P
authors.initials: DP
authors.lastname: West
authors.forename: Mario E
authors.initials: ME
authors.lastname: Lacouture
mesh_terms: D017677:Age Distribution; D000368:Aged; D000554:Ambulatory Care Facilities; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001691:Biological Therapy / Q000009:adverse effects* / Q000379:methods; D003430:Cross-Sectional Studies; D003880:Dermatology / Q000379:methods; D003875:Drug Eruptions / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005076:Exanthema / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000009:adverse effects* / Q000379:methods; D009369:Neoplasms / Q000188:drug therapy / Q000473:pathology; D011537:Pruritus / Q000139:chemically induced / Q000453:epidemiology; D011788:Quality of Life; D012017:Referral and Consultation; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents