[Cutaneous side effects of EGFR inhibitors--appearance and management]

Abstract

Epidermal growth factor receptor (EGFR) inhibitors such as cetuximab, erlotinib, panitumumab und gefitinib, are increasingly used for the treatment of advanced, metastatic, or recurrent tumours like colorectal carcinoma, non-small cell lung cancer (NSCLC), squamous cell carcinoma of the head and neck (SCCHN) and pancreatic cancer. For this reason the treatment of common cutaneous side effects of EGFR inhibitors has become important: they stigmatize the patient in daily life and may lead to efficacious therapie being discontinued. Depending on the particular EGFR inhibitor, an acneiform rash occurs in 30 to 90 % of patients. Severity, site, stage of eruptions and individual response influence the decision of treatment in the given case. It follows the forms of treatment for acne and rosacea, including topical and systemic antibiotics for their antimicrobial effect and anti-inflammatory effect, sometimes in combination with topical steroids. After several weeks additional sebostatic skin reactions, paronychia and changes in the hair structure may occur, calling for individualized treatment. Only multidisciplinary collaboration between oncologists, radiotherapist and dermatologists may provide an optimal patient care. This article gives an overview of the occurrence and latest treatment options of the cutaneous side effects caused by treatment with EGFR inhibitors.