![]() ![]() The pathogenesis of EGFRis-induced skin rash is not well clarified. With this aim, we have established a dermocosmetological outpatient clinic for cancer patients at the Department of Clinical Medicine and Surgery, University of Naples Federico II in collaboration with the Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami. Several recent prospective studies have addressed and evaluated different therapies to mitigate or reduce the severity of EGFRis-associated skin rash. Acneiform rash can be distinguished from acne vulgaris by the monotonous lesion morphology. This skin reaction is defined ‘acneiform’ rash because the lesions, such as papules, nodules, and pustules, look like acne, but in these patients, comedones, which are a distinguishing factor of acne, are never present. ![]() It is not well known why monoclonal antibodies are the most frequent trigger of acneiform rash. Acneiform rash is a dose-dependent skin drug reaction, which usually develops in the first 1-2 weeks, peaks at 3-4 weeks on therapy, and its intensity decreases after 2 weeks but can often persist over some months. The most common cutaneous side effect is a dose-dependent follicular papulopustular (acneiform) eruption on the face, scalp, chest, and upper back (fig. This condition can affect the quality of life of these patients and can sometimes lead to a discontinuation of the antineoplastic therapy. EGFR is expressed in many different cell types in normal tissues, such as epithelial tissue, skin, hair follicles, and the gastrointestinal tract, and during treatment with EGFRis cutaneous adverse events occur in about 65-90% of patients. EGFR can be inhibited by the monoclonal antibodies cetuximab (Erbitux®) and panitumumab (Vectibix®), and by the small molecule tyrosine kinase inhibitors erlotinib (Tarceva®) and gefitinib (Iressa®). EGFR belongs to a family (ErbB) of tyrosine kinase receptors which regulate tumor cell differentiation, survival, and proliferation. In this review, we summarize the state of the art of the epidemiology, pathogenesis, and treatment of EGFRis acneiform rash, and we describe our outpatient clinical experience.Īcneiform rash is the most common side effect of epidermal growth factor receptor (EGFR) inhibitors (EGFRis). An interdisciplinary network of physicians can improve the quality of life of the cancer patients, focusing on such important aspects as dermocosmetological skin care, but also on the evaluation of new therapeutic and diagnostic algorithms in order to make further progress in the field of prevention. Several recent prospective studies have addressed and evaluated different interventions to mitigate or reduce the severity of EGFRis-associated skin rash. ![]() Acneiform rash is the most common side effect of epidermal growth factor receptor (EGFR) inhibitors (EGFRis), and it occurs in 50-100% of patients. ![]()
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