Instrumental evaluation sensitively detects subclinical skin changes by the epidermal growth factor receptor...

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Skin toxicities, including acneiform eruption (AfE), are frequent side effects of epidermal growth factor receptor inhibitors (EGFRI).
• Predictive factors and early detection methods for severe AfE remain unclear.
• Understanding these changes is crucial for managing cancer patients undergoing EGFRI therapy.

Purpose of the Study:

• To identify early and sensitive parameters for detecting skin changes induced by EGFRI.
• To investigate the relationship between baseline skin characteristics and the development of severe AfE.
• To elucidate risk factors associated with severe AfE in patients treated with EGFR tyrosine kinase inhibitors (TKI) and anti-EGFR antibodies.

Main Methods:

• Serial instrumental measurements of transepidermal water loss (TEWL), skin hydration, lipid levels, and erythema/melanin index were performed.
• 19 patients treated with EGFR-TKI (afatinib/erlotinib) were monitored for 2 weeks.
• 20 patients treated with anti-EGFR antibody (cetuximab) were monitored for 8 weeks.

Main Results:

• Elevated cheek TEWL was observed within 7 days in patients developing grade 2 or higher AfE (AfE ≥ Gr2) treated with afatinib/erlotinib.
• Significantly decreased cheek skin hydration was noted at weeks 2 and 6 in cetuximab-treated patients with AfE ≥ Gr2.
• Higher baseline cheek skin surface lipids and erythema index were associated with AfE ≥ Gr2 in both treatment groups.

Conclusions:

• Instrumental evaluation reveals rapid inflammatory skin changes caused by EGFRI.
• Oily skin (higher baseline lipids) is identified as a significant risk factor for developing severe AfE.
• Early detection of skin changes using instrumental parameters can aid in managing EGFRI-induced dermatologic toxicities.