Tjin-A-ton M L R, van Montfrans C, Koldenhof J J, Sigurdsson V, Voest E E, Witteveen P O
Universitair Medisch Centrum Utrecht, divisie Interne Geneeskunde en Dermatologie, Heidelberglaan 100, 3584 CX Utrecht.
Ned Tijdschr Geneeskd. 2007 Apr 28;151(17):945-52.
Inhibition of the epidermal growth-factor receptor (EGFR) is a new strategy in the treatment of solid malignancies. Two men, aged 65 and 59 years, with a metastasized renal carcinoma and a 51-year-old man with a metastasized melanoma developed an acneiform eruption during EGFR inhibition. The second and third patient also developed paronychia. Treatment in all patients consisted of antiseptics and topical antibiotics; the first and third patient also received an oral antibiotic. Withdrawal of the EGFR inhibitor because of progression of the disease led to complete recovery of the cutaneous lesions in the first and the third patient; both died after several months. In the second patient, the side effects reached an acceptable level during continued EGFR therapy. EGFR inhibition is usually accompanied by cutaneous side effects. An acneiform eruption is seen in up to 90% of all treated patients. Other side effects include dry skin, and nail and hair changes. The pathogenesis of these side effects is related to inhibition of EGFR signalling pathways in the skin, but is not yet fully understood. The treatment of EGFR inhibitor-mediated cutaneous toxicity is based mainly on clinical experience.
抑制表皮生长因子受体（EGFR）是治疗实体恶性肿瘤的一种新策略。两名分别为65岁和59岁的男性患有转移性肾癌，一名51岁男性患有转移性黑色素瘤，他们在EGFR抑制治疗期间出现了痤疮样皮疹。第二例和第三例患者还出现了甲沟炎。所有患者的治疗均包括使用抗菌剂和局部抗生素；第一例和第三例患者还接受了口服抗生素治疗。由于疾病进展而停用EGFR抑制剂后，第一例和第三例患者的皮肤病变完全恢复；两人均在数月后死亡。在第二例患者中，继续进行EGFR治疗期间副作用达到了可接受的水平。EGFR抑制通常伴有皮肤副作用。在所有接受治疗的患者中，高达90%会出现痤疮样皮疹。其他副作用包括皮肤干燥以及指甲和毛发变化。这些副作用的发病机制与皮肤中EGFR信号通路的抑制有关，但尚未完全明确。EGFR抑制剂介导的皮肤毒性的治疗主要基于临床经验。
