Korean J Dermatol.  2011 Feb;49(2):131-140.

Cutaneous Adverse Reactions Associated with Epidermal Growth Factor Receptor Inhibitors

• Lee HJ
• Sim HS
• Seo JK
• Lee D
• Sung HS

Abstract

BACKGROUND
Cutaneous adverse reactions are often observed during chemotherapy with epidermal growth factor receptor (EGFR) inhibitors including papulopustular eruptions, xerosis and paronychia.
OBJECTIVE
To investigate and compare the cutaneous adverse reactions induced by EGFR inhibitors including erlotinib, gefitinib and cetuximab which have commonly been used as chemotherapeutic agents in Korea.
METHODS
We reviewed cutaneous adverse effects through the medical records and clinical photographs of 43 Korean patients who had been treated with erlotinib, gefitinib or cetuximab at Pusan Paik Hospital between June 2003 and January 2010.
RESULTS
Papulopustular eruptions occurred in 28 patients (65.1%); they were easily controlled by topical benzoyl peroxide, clindamycin and a retinoid, or by oral minocycline and tetracycline. There were no significant differences in incidence, duration and severity grades of papulopustular eruptions among EGFR inhibitors. In contrast to previous studies, the frequency and severity of papulopustular eruptions were not significantly correlated with treatment responses to EGFR inhibitors. Xerosis appeared in 14 patients (41%), and was easily controlled by topical emollients and steroids, and by systemic steroids and antihistamines. Paronychia occurred in 8 patients (18.6%) and were controlled by conservative treatments.
CONCLUSION
Papulopustular eruptions, xerosis and paronychia are common cutaneous adverse reactions associated with EGFR inhibitors and there are no significant differences in adverse cutaneous reactions among EGFR inhibitors. As these cutaneous adverse reactions are relatively easily controlled with treatment, it will be helpful to detect and treat these adverse reactions early, including reassuring the patients, which should increase compliance of patients during treatment with EGFR inhibitors.

Keyword

Cetuximab; Epidermal growth factor receptor; Erlotinib; Gefitinib; Papulopustular eruption

MeSH Terms

Antibodies, Monoclonal, Humanized
Benzoyl Peroxide
Clindamycin
Compliance
Emollients
Epidermal Growth Factor
Histamine Antagonists
Humans
Incidence
Medical Records
Minocycline
Paronychia
Quinazolines
Receptor, Epidermal Growth Factor
Steroids
Tetracycline
Cetuximab
Erlotinib Hydrochloride
Antibodies, Monoclonal, Humanized
Benzoyl Peroxide
Clindamycin
Emollients
Epidermal Growth Factor
Histamine Antagonists
Minocycline
Quinazolines
Receptor, Epidermal Growth Factor
Steroids
Tetracycline