[Skin eruptions as an adverse reaction to epidermal growth-factor receptor inhibitors]

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Epidermal growth-factor receptor (EGFR) inhibitors represent a novel therapeutic strategy for advanced solid tumors.
• Cutaneous side effects are common during EGFR inhibition therapy, impacting patient adherence and quality of life.

Observation:

• Three patients with metastatic renal carcinoma or melanoma developed acneiform eruptions during EGFR inhibition.
• Two of these patients also experienced paronychia, a nail condition, alongside the skin eruption.
• Treatment involved topical antiseptics, topical antibiotics, and in some cases, oral antibiotics.

Findings:

• Complete resolution of cutaneous lesions was observed in two patients upon discontinuation of EGFR inhibitors due to disease progression.
• One patient achieved acceptable symptom levels while continuing EGFR inhibitor therapy.
• Acneiform eruptions affect up to 90% of patients on EGFR inhibitors, with dry skin and nail/hair changes also noted.

Implications:

• EGFR inhibitor-mediated cutaneous toxicity management relies heavily on clinical experience and supportive care.
• Understanding the pathogenesis of these side effects, linked to EGFR signaling pathways in the skin, requires further investigation.
• Balancing the benefits of EGFR inhibition with the management of dermatological toxicities is crucial for effective cancer treatment.