<\/span><\/h2>\nEvery year 10.9 million people worldwide are diagnosed with Cancer<\/span>, and that incidence<\/span> is increasing. This increase reflects the growing world population and the fact that people live longer. Chemotherapy is a crucial component to all cancer management, and with this increasing burden of cancer, both clinicians and patients will see an increasing incidence of chemotherapy-related skin. toxicity<\/span>.<\/p>\n<\/span>What are the skin rashes associated with chemotherapy?<\/span><\/h2>\n\n- Acral<\/span> erythema<\/span> <\/li>\n
- Alopecia<\/span> (hair<\/span> lost) <\/li>\n
- Photosensitivity<\/span> (increased sensitivity to sunlight) <\/li>\n
- Remember reactions <\/li>\n
- Acneform (pimple type) rashes<\/span> <\/li>\n
- Skin necrosis<\/span> <\/li>\n
- Neutrophils<\/span> eccrine<\/span> hydradenitis <\/li>\n
- Eccrine scaly<\/span> metaplasia<\/span> <\/li>\n
- Hyperpigmentation<\/span> <\/li>\n
- Nail changes <\/li>\n
- Mucositis<\/span> <\/li>\n
- Sclerotic<\/span> dermal<\/span> reactions<\/li>\n
- \nToxic<\/span> erythema<\/span> chemotherapy<\/li>\n
- Vascular<\/span> injury <\/li>\n
- Xerosis<\/span><\/span> <\/li>\n
- Other reactions <\/li>\n<\/ul>\n
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<\/span>\n Acral erythema<\/span><\/h2>\nAcral erythema is also known as palmoplantar<\/span> erythrodystesia (PPE) or hand-foot syndrome<\/span>. It manifests as painful erythema (reddening of the skin) of the palms and soles, with or without bullas<\/span> (large blisters). Swelling, tingling, hyperkeratosis<\/span>, fissure<\/span> and ulceration<\/span> It can also happen. These symptoms may be preceded by dysesthesia<\/span> (Altered skin sensation). The pain of this eruption<\/span> It can be so severe that daily activities are limited.<\/p>\nIf recognized early, the usual course of acral erythema is peeling<\/span> (detachment of the outer layers of the skin) followed by re-epithelialization (new growth of the outer layers of the skin). The risk increases with each dose of chemotherapy.<\/p>\nThe exact mechanism is unknown, but the skin of the hands and feet is postulated to favor a higher level of certain chemotherapy drugs that cause direct toxicity to skin cells.<\/p>\n
Chemotherapy toxic erythema is a similar reaction that spreads to involve other sites, particularly intertriginous<\/span> sites like armpits<\/span> and groin, and knees.<\/p>\n\n<\/span>Acral erythema or hand-foot syndrome<\/span><\/h5>\n<\/section>\n\n\n
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Foot and hand syndrome due to sorafenib<\/p>\n
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Foot and hand syndrome due to sorafenib<\/p>\n
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Foot and hand syndrome due to sorafenib<\/p>\n<\/p><\/div>\n<\/section>\n
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<\/span>What drugs are responsible?<\/span><\/h3>\nThe most associated medications include:<\/p>\n
\n- Capecitabine<\/li>\n
- Cyclophosphamide<\/li>\n
- Cytarabine<\/li>\n
- Daunorubicin<\/li>\n
- Docetaxel<\/li>\n
- Doxorubicin<\/li>\n
- Etoposide<\/li>\n
- Fluorouracil<\/li>\n
- Floxuridine<\/li>\n
- Hydroxyurea<\/li>\n
- Idarubicin<\/li>\n
- \nInterleukin<\/span>-2<\/li>\n
- Lapatinib <\/li>\n
- Mercaptopurine<\/li>\n
- Methotrexate<\/li>\n
- Mitoxantrone<\/li>\n
- Paclitaxel<\/li>\n
- Sorafenib<\/li>\n
- Sunitinib <\/li>\n
- Tegafur<\/li>\n
- Vinblastine<\/li>\n
- Vincristine<\/li>\n
- Vinorelbina<\/li>\n<\/ul>\n
<\/span>Acral Erythema Treatment<\/span><\/h3>\nOften stopping or reducing the dose of the chemotherapy drug will result regression<\/span> acral erythema for about 14 to 28 days. Supportive care may include wound dressings, analgesia (pain relief), and cold compresses.<\/p>\n<\/span>\n Alopecia<\/span><\/h2>\nAlopecia (hair loss) is the most common side effect of cancer treatment, and is often the most distressing to a patient's self-image. It occurs 7-10 days after treatment and continues to progress for 2-3 months.<\/p>\n
There are two main ways that chemotherapy drugs cause alopecia:<\/p>\n
\n- \n Anagen<\/span> effluvium (most common): refers to the toxic effects on hair cells that divide rapidly<\/li>\n
- \n Telogen<\/span> effluvium: refers to increased shedding of normal hair cells<\/li>\n<\/ul>\n
Alopecia is often temporary and resolves after stopping treatment, but some chemotherapy drugs like busulfan and cyclophosphamide can cause permanent hair loss.<\/p>\n
<\/span>What drugs are responsible?<\/span><\/h3>\nMost chemotherapy drugs cause alopecia, but the most common culprits are:<\/p>\n
\n- Taxanes (for example, paclitaxel and docetaxel)<\/li>\n
- Anthracyclines (eg, doxorubicin, idarubicin, epirubicin, and mitoxantrone).<\/li>\n<\/ul>\n
<\/span>Treatment of drug-induced alopecia.<\/span><\/h3>\nVarious strategies have been tried to reduce alopecia, such as:<\/p>\n
\n- Cooling the scalp to 24 \u00b0 C<\/li>\n
- Using a headband to reduce the amount of chemotherapy given to the scalp<\/li>\n
- Immune treatment to regulate upward cytokines<\/span> (Hormone-like proteins secreted by cells)<\/li>\n<\/ul>\n
Unfortunately, none have been consistently proven effective. It is important to inform patients about this possible side effect and provide a wig.<\/p>\n
<\/span>Other capillary abnormalities<\/span><\/h3>\nEpidermal<\/span> growth factor<\/span> receiver<\/span> Inhibitor treatment (EGFR) has been reported to slow down hair growth, brittle hair, and abnormally thick hair.<\/p>\n<\/span>\n Photosensitivity<\/span><\/h2>\nCertain chemotherapy drugs cause photosensitivity (increased sensitivity to sunlight) causing sunburn with minimal sun exposure.<\/p>\n
<\/span>What drugs are responsible?<\/span><\/h3>\nThe chemotherapy drugs that most commonly cause this are:<\/p>\n
\n- Methotrexate <\/li>\n
- Fluorouracil<\/li>\n
- Dacarbazine<\/li>\n<\/ul>\n
<\/span>Treatment of drug-induced photosensitivity.<\/span><\/h3>\nPatients should be informed of this possible side effect and protected from the sun. This involves the use of sunscreen and protective clothing.<\/p>\n
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<\/span>\n Remember reactions<\/span><\/h2>\n