Chemotherapy causes many adverse effects on the skin. Although the most common are hyperpigmentation, erythema and phototoxicity , there are other specific skin disorders, associated with each drug. Miriam Mendez, deputy of Medical Oncology Hospital Puerta de Hierro, Madrid, TodoDermo explained that “in recent years have appeared new biological therapies that produce special skin toxicities .” “The group EGFR inhibitors such as gefitinib, erlotinib or afatinib produce rashes on seborrheic areas 80 percent of patients.” RAF inhibitors as vemurafenib and dabrafenib “produce generalized rash and photosensitivity”. They requirethe patient avoid sun exposure and use sunscreen creams several times throughout the day. “Monoclonal antibodies as cetuximab or panitumumab also have various skin effects and nail changes”, this latter group produces toxocidad in over 90 percent of patients , said Mendez, and usually p resenting one acneiform eruption , especially on the face, and pustular lesions in the upper body.
As stated in the pathogenesis of most cutaneous reactions to chemotherapy it is unknown, although “it is speculated that the skin toxicity deriving from the action occurs antimitotic drugs by hypersensitivity reactions “. Changes in skin color, feeling of tightness, itching and pain are the most common symptoms of toxicity. “There may also be cracks or crevices in areas where the skin is thick. If lesions are left to evolve can sobreinfectarse causing more serious local disturbances , “he adds.
The treatment of these lesions is moisturizing, emollient creams and antihistamines if lesions occur with pruritus. In this sense, the pharmacist may refer the patient to medical assessment “when the initial topical measures are not sufficient or when suspected superinfection”. Mendez noted that in some cases be necessary to add topical steroids treatment , and even systemic steroids, “in certain situations the use of antibiotics is also recommended for several weeks.”
During treatment, the patient’s skin care usually recommend use of moisturizers alcohol and ” shower gels based on oats .” It is also recommended to apply sunscreen several times a day “with physical filters such as zinc oxide, talc or kaolin.” Mendez warns that “before starting the treatments, you should treat calluses or hyperkeratosis .” Other recommendations to relieve lesions is “apply creams with urea or salicylic acid and avoid too constrictive footwear”.