Over the last two decades, a number of new chemotherapeutic agents have been used for the treatment of cancer. These drugs may be classified according to their mechanism of action: signal transduction inhibitors (epidermal growth factor receptor EGFR antagonists and multikinase inhibitors), proteasome inhibitors, spindle inhibitors (xaxanes and vinca alkaloids), antimetabolites (purine analogs and pyrimidine analogs), genotoxic agents.
Chemotherapeutic agents have significant side effects. Although skin toxicity is rarely life-threatening it often worsens the patients’ quality of life.
It is well known that, cytotoxic agents like Cyclophosphamide, Chlorambucil, Busulfan, Procarbazine can cause side-effects to hair and nails (alopecia, paronychia, melanonychia, and other abnormalities), on skin barrier (skin rash, skin dryness, hyperpigmentation) and on mucose (Steven-Johnson Syndrome and toxic epidermic necrolysis).
In recent years, targeted therapy has considerably increased survival rate in patients affected by important solid tumors of kidney, lungs, colon-rectum, breast and liver. Among the innovative therapeutic strategies in chemotherapy, the EGFR inhibitors (Cetuximab, Panitumumab, Erlotinib, Gefitinib) approved for lung and colon-rectum tumors showed an increasing skin toxicity, causing widespread skin dryness (in more than 90% of patients) and a follicular rash which can be complicated by pruritus, pain and infections.
Despite the benefits of all these chemotherapic agents, toxic effects on the skin may eventually result in poor compliance of patients and interruptions or discontinuation of antineoplastic therapy. Such toxic effects of the skin may also significantly reduce the quality of life of oncological patients.
Sourced from: Chemotherapy and Skin Reactions
Journal of Experimental & Clinical Cancer Research 2012
Gabriella Fabbrocini, Norma Cameli
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