Korean journal of dermatology (대한피부과학회지)

Korean Dermatological Association (대한피부과학회)
권호 표지

Analysis of Dermatologic Diseases in Patients Receiving Anticancer Treatments: A Retrospective Study of 140 Cases

항암제와 관련된 피부이상반응에 대한 고찰

  • Kang, Jeong Nan (Department of Dermatology, Inje University Busan Paik Hospital) ;
  • Kim, Do Hyeong (Department of Dermatology, Inje University Busan Paik Hospital) ;
  • Seol, Jung Eun (Department of Dermatology, Inje University Busan Paik Hospital) ;
  • Jung, So Young (Department of Dermatology, Inje University Haeundae Paik Hospital) ;
  • Wang, Han Young (Department of Dermatology, Inje University Haeundae Paik Hospital) ;
  • Kim, Hyojin (Department of Dermatology, Inje University Busan Paik Hospital)
  • 강정난 (인제대학교 부산백병원 피부과) ;
  • 김도형 (인제대학교 부산백병원 피부과) ;
  • 설정은 (인제대학교 부산백병원 피부과) ;
  • 정소영 (인제대학교 해운대백병원 피부과) ;
  • 왕한영 (인제대학교 해운대백병원 피부과) ;
  • 김효진 (인제대학교 부산백병원 피부과)
  • Received : 2016.09.08
  • Accepted : 2016.11.15
  • Published : 2017.02.28

⟨ Previous Next ⟩

Abstract

Background: A number of anticancer agents are known to induce many adverse reactions in the skin. Related cutaneous adverse drug reactions influence the morbidity, mortality, and anti-cancer regimen of the patients. A multidisciplinary approach to cancer management has been emphasized. Objective: To identify the causative anticancer agents and frequency of adverse reactions in the skin. Methods: We retrospectively reviewed the medical records of patients who consulted at the Dermatology Department of Busan Paik Hospital and Haeundae Paik Hospital from January 2013 to February 2015. Results: A total of 140 patients were enrolled. Among the 45 patients treated with antimetabolite analogs (30 cytarabine, 7 gemcitabine, 3 methotrexate, 2 fludarabine, 2 doxifluridine, and 1 decitabine), exanthematous drug eruption (49.1%) was the most common reaction, followed by hand-foot syndrome (28.3%). Among the 35 patients treated with fluorouracil (22 5-fluorouracil and 13 capecitabine), hand-foot syndrome (47.2%) was the most common, followed by acneiform eruption (25.0%). Among the 24 patients treated with epidermal grow factor receptor inhibitors (10 erlotinib, 10 cetuximab, and 4 gefitinib), acneiform eruption (54.8%) was the most common, followed by xerosis (19.4%). Among the 11 patients treated with anthracyclines (9 doxorubicin, 1 daunorubicin, and 1 idarubicin), acneiform eruption (45.5%) was the most common, followed by hand-foot syndrome (36.4%). Among the 7 patients treated with taxanes (4 docetaxel and 3 paclitaxel), hand-foot syndrome (42.8%) was the most common. Among the 6 patients treated with angiogenesis-inducing inhibitors (3 sorafenib, 2 pazopanib, and 1 sunitinib), hand-foot skin reaction (66.7%) was the most common. Only 2 patients (1.4%) changed treatments due to intolerable skin reactions. Conclusion: Clinicians should be aware of the various skin reactions of anticancer agents and predict their clinical course effectively.

Keywords

References

  1. Farshchian M, Ansar A, Zamanian A, Rahmatpour-Rokni G, Kimyai-Asadi A. Drug-induced skin reactions: a 2-year study. Clin Cosmet Investig Dermatol 2015;8:53-56
  2. Hunziker T, Kunzi UP, Braunschweig S, Zehnder D, Hoigne R. Comprehensive hospital drug monitoring (CHDM): adverse skin reactions, a 20-year survey. Allergy 1997;52:388-393 https://doi.org/10.1111/j.1398-9995.1997.tb01017.x
  3. Wyatt AJ, Leonard GD, Sachs DL. Cutaneous reactions to chemotherapy and their management. Am J Clin Dermatol 2006;7:45-63 https://doi.org/10.2165/00128071-200607010-00005
  4. Cho KH. Cutaneous adverse reactions of new anti-cancer agents. Korean J Dermatol 2010;48:257-265
  5. Susser WS, Whitaker-Worth DL, Grant-Kels JM. Mucocutaneous reactions to chemotherapy. J Am Acad Dermatol 1999;40:367-398 https://doi.org/10.1016/S0190-9622(99)70488-3
  6. Revuz J, Valeyrie-Allanore L. Drug reactions, In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. 3rd ed. Philadelphia: Elsevier Saunders, 2012:335
  7. Hahm JH. A comparative study on clinical evaluation of inpatient dermatology consultation between 1976 and 1991. Korean J Dermatol 1992;30:651-658
  8. Crowson AN, Brown TJ, Magro CM. Progress in the understanding of the pathology and pathogenesis of cutaneous drug eruptions : implications for management. Am J Clin Dermatol 2003;4:407-428 https://doi.org/10.2165/00128071-200304060-00005
  9. Hernandez-Salazar A, Rosales SP, Rangel-Frausto S, Criollo E, Archer-Dubon C, Orozco-Topete R. Epidemiology of adverse cutaneous drug reactions. A prospective study in hospitalized patients. Arch Med Res 2006;37:899-902 https://doi.org/10.1016/j.arcmed.2006.03.010
  10. Patel TK, Thakkar SH, Sharma D. Cutaneous adverse drug reactions in Indian population: A systematic review. Indian Dermatol Online J 2014;5:S76-86 https://doi.org/10.4103/2229-5178.146165
  11. Son YM, Lee JR, Roh JY. Causality assessment of cutaneous adverse drug reactions. Ann Dermatol 2011;23:432-438 https://doi.org/10.5021/ad.2011.23.4.432
  12. Reyes-Habito CM, Roh EK. Cutaneous reactions to chemotherapeutic drugs and targeted therapies for cancer: Part I. Conventional chemotherapeutic drugs. J Am Acad Dermatol 2014;71:203.e1-e12 https://doi.org/10.1016/j.jaad.2014.04.014
  13. Reyes-Habito CM, Roh EK. Cutaneous reactions to chemotherapeutic drugs and targeted therapies for cancer: Part II. Targeted therapy. J Am Acad Dermatol 2014;71:217.e1-e11 https://doi.org/10.1016/j.jaad.2014.04.013
  14. Sanches Junior JA, Brandt HR, Moure ER, Pereira GL, Criado PR. Adverse mucocutaneous reactions to chemotherapeutic agents: part I. An Bras Dermatol 2010;85:425-437 https://doi.org/10.1590/S0365-05962010000400003
  15. Criado PR, Brandt HR, Moure ER, Pereira GL, Sanches Junior JA. Adverse mucocutaneous reactions related to chemotherapeutic agents: part II. An Bras Dermatol 2010;85:591-608 https://doi.org/10.1590/S0365-05962010000500002
  16. Yamamoto T. Erlotinib-induced adverse skin reactions. Open Allergy J 2013;6:22-29 https://doi.org/10.2174/1874838420130904002
  17. Park YH, Ryoo BY, Choi SJ, Kim HT. A phase II study of capecitabine and docetaxel combination chemotherapy in patients with advanced gastric cancer. Br J Cancer 2004;90:1329-1333 https://doi.org/10.1038/sj.bjc.6601724
  18. Chung WK, Chang SE, Ryu MH, Lee MW, Choi JH, Moon KC, et al. Clinical features of the cutaneous adverse events induced by combination chemotherapy that includes cetuximab (Erbitux(R)). Korean J Dermatol 2008;46:1478-1487
  19. Blum JL, Jones SE, Buzdar AU, Lorusso PM, Kuter I, Vogel C, et al. Multicenter phase II study of capecitabine in paclitaxel-refractory metastatic breast cancer. J Clin Oncol 1999;17:485-493 https://doi.org/10.1200/JCO.1999.17.2.485
  20. Roujeau JC, Allanore L, Liss Y, Mockenhaupt M. Severe cutaneous adverse reactions to drugs (SCAR): definitions, diagnostic criteria, genetic predisposition. Dermatol Sinica 2009;27:203-209
  21. Sasidharanpillai S, Riyaz N, Khader A, Rajan U, Binitha MP, Sureshan DN. Severe cutaneous adverse drug reactions: a clinicoepidemiological study. Indian J Dermatol 2015;60:102