Wollenberg A, Kroth J, Hauschild A, Dirschka T
Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians Universität München.
Dtsch Med Wochenschr. 2010 Jan;135(4):149-54. doi: 10.1055/s-0029-1244831. Epub 2010 Jan 25.
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.
表皮生长因子受体（EGFR）抑制剂，如西妥昔单抗、厄洛替尼、帕尼单抗和吉非替尼，越来越多地用于治疗晚期、转移性或复发性肿瘤，如结直肠癌、非小细胞肺癌（NSCLC）、头颈部鳞状细胞癌（SCCHN）和胰腺癌。因此，治疗EGFR抑制剂常见的皮肤副作用变得很重要：这些副作用在日常生活中会给患者带来困扰，可能导致有效的治疗中断。根据具体的EGFR抑制剂不同，30%至90%的患者会出现痤疮样皮疹。皮疹的严重程度、部位、阶段以及个体反应会影响特定病例的治疗决策。治疗遵循痤疮和酒渣鼻的治疗方式，包括使用局部和全身抗生素，利用其抗菌和抗炎作用，有时还会与局部类固醇联合使用。几周后可能会出现额外的皮脂分泌抑制性皮肤反应、甲沟炎和头发结构变化，需要进行个体化治疗。只有肿瘤学家、放疗师和皮肤科医生之间的多学科合作才能为患者提供最佳护理。本文概述了EGFR抑制剂治疗引起的皮肤副作用的发生情况和最新治疗选择。
