Assessment of demodex presence in acne-like rash associated with cetuximab.
BACKGROUND
Cetuximab is an epidermal growth factor receptor inhibitor. It is frequently used in the treatment of solid tumors. However, it has a high potential to cause acne-like rash. Demodex mites, which are known to increase in number in immunosuppressive circumstances, are closely related to the acneiform lesions.


OBJECTIVE
The aim of this study is to evaluate the presence of demodex mites in acne-like rash that appears under the treatment of Cetuximab.


METHODS
We reviewed the medical records of patients who applied to our clinic with cetuximab induced papulopustular rashes between November 2014 and March 2016. Demodex sampling was performed by standardized skin surface biopsy (SSSB) in a total of 11 patients (eight males and three females). Infestation was defined as at least 5 living parasites/cm2of skin.


RESULTS
Upon the SSSB examination in 10 out of the 11 patients, no demodex mites were detected. Demodex mites were found in only one of the patients. This patient, in whom two dead Demodex folliculorums were found through facial sampling, was also regarded as negative since his demodex density was under the threshold limit value.


CONCLUSIONS
In this study, it has been concluded that acne-like rash that develops under the treatment of cetuximab is not related to the presence of demodex mites. Papulopustular eruptions that develop under cetuximab treatment should not be directly correlated with the presence of demodex; first SSSB and demodex presence should be evaluated.
a Dermatology Department and.
Deniz
D
Aksu Arıca
b Medical Oncology Department, School of Medicine, Karadeniz Technical University , Trabzon , Turkey , and.
Turkan
T
Ozturk Topcu
a Dermatology Department and.
Leyla
L
Baykal Selçuk
a Dermatology Department and.
Savas
S
Yaylı
a Dermatology Department and.
Unzile
U
Seyman
c Medical Oncology, Kanuni Eğitim Araştirma Hastanesi , Trabzon , Turkey.
Evren
E
Fidan
a Dermatology Department and.
Sevgi
S
Bahadır
b Medical Oncology Department, School of Medicine, Karadeniz Technical University , Trabzon , Turkey , and.
Halil
H
Kavgacı
D000328:Adult; D000368:Aged; D000818:Animals; D000074322:Antineoplastic Agents, Immunological / Q000009:adverse effects*; D000068818:Cetuximab / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008924:Mite Infestations; D008925:Mites; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*
D000074322:Antineoplastic Agents, Immunological; D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors; D000068818:Cetuximab
Acne; cetuximab; demodex; drug rash; parasitology