Skin changes
Nearly all drugs used for treating cancer can cause skin rash.
Targeted therapeutics
- A new class of drugs for cancer treatment has been developed in the recent years.
- Drugs target a gene called EGF receptor (epidermal growth factor receptor).
- These drugs are used to treat lung cancer, colorectal cancer, and head and neck cancer.
- Some other cancers can also be treated with these drugs with some benefit.
Side effects of targeted therapeutics:
- They can cause many skin changes including rash, acne, hair loss, eyelash changes, skin fissures of fingertips and heels and others.
- The skin rash often appears similar to acne a teenager experiences during puberty.
- 80% to 100% of patients receiving one of these drugs can develop skin rash or other changes.
- Sometimes, these skin changes can lead to infection that requires treatment with antibiotics.
Cause of side effects:
- The reason skin rash is so common with this class of drugs is that the gene is very active in skin tissue and makes a large amount of its protein on the surface of skin cells.
These common targeted therapeutics drugs include:
- Cetuximab (Erbitux)
- Panitumumab (Vectibix)
- Erlotinib (Tarceva).
Efficacy of targeted therapeutics
- Interestingly, it has been observed that the severity of skin rash is often associated with efficacy of the drug in treating cancer.
Most common skin rash:
- The most common rash is called red papulopustules. The rash is similar to acne, can develop on the face and scalp, can involve the body, and in severe cases can involve the arms and legs.
- The rash can cause uncomfortable itching.
- It usually occurs 8-10 days after the treatment is started and peaks at around 2 weeks.
Treatment for skin rash:
- Treatment includes using skin moisturizer (sauner lotion), using sunscreen when outdoor, topical steroid (1% hydrocortisone), and a topical antibiotic called clindamycin phosphate jelly.
- Clindamycin jelly can decrease the amount and severity of skin rash and severity but it can cause dry skin and itching.
- In patients with severe skin rash, your doctor may prescribe an oral antibiotic such as Minocycline or Doxycycline.
- A referral to see a dermatologist is also appropriate.
Other skin changes:
- Some patients develop xerosis, which causes fissures of fingertips and heels.
- Some develop paronichia, a type of infection on the fingertips.
- Some patients can develop scarring of skin and hair loss from the scalp.
Other chemotherapy drugs that can cause skin rashes:
Many drugs can cause skin rashes. Taxotere, 5-FU, xeloda, doxil, and other drugs can cause skin discoloration of hands and feet with moisture and irritation.
- Hand-foot syndrome occurs when skin blistering and peeling occurs.
- This condition is usually self-limited, meaning it usually improves or resolves after the chemotherapy drug is discontinued or the dose is reduced.
Drugs that can cause pustule and acne-like skin rash:
- Bowel function
- Eye changes
- Hearing loss
- Heart health
- Kidney and liver function
- Lung function
- Skin changes
