Department of Dermatology, A. Sygros Hospital, Athens, Greece. drviknik @ yahoo.com
Dermatology. 2010;220(3):243-8. doi: 10.1159/000277430. Epub 2010 Jan 22.
Cutaneous side effects of epidermal growth factor receptor inhibitors (EGFRIs) are very frequent and well known. The aim of our study was to investigate the efficacy and safety of pimecrolimus 1% cream in the treatment of papulopustular eruption caused by EGFRIs and to review the relevant literature on therapeutic approaches.
Twenty cancer patients being treated with EGFRIs were included in the study. Nine of the patients showed grade 1 and 11 showed grade 2 papulopustular eruption. All patients were treated with pimecrolimus 1% cream, which was applied twice daily. Patients with grade 2 eruption also received systemic minocycline 100 mg/day.
All patients with grade 1 eruption responded to treatment, with 4/9 experiencing complete resolution of the lesions 2 weeks after the initiation of treatment. Five out of 11 patients with grade 2 eruption had more than 50% improvement in erythema and pustules, and 1 had complete resolution of the skin lesions. Two patients did not respond to treatment but were significantly improved after substitution of pimecrolimus 1% cream with metronidazole 1% cream. No side effects were recorded.
Our case series shows that pimecrolimus cream may be an effective and safe approach in the management of papulopustular eruption related to EGFRIs.
表皮生长因子受体抑制剂（EGFRIs）的皮肤副作用非常常见且广为人知。我们的研究旨在探讨吡美莫司 1%乳膏治疗 EGFRIs 引起的脓疱性疹的疗效和安全性，并回顾相关的治疗方法文献。
本研究纳入了 20 名正在接受 EGFRIs 治疗的癌症患者。其中 9 名患者表现为 1 级脓疱性疹，11 名患者表现为 2 级脓疱性疹。所有患者均接受吡美莫司 1%乳膏治疗，每日两次。2 级皮疹患者还接受米诺环素 100mg/天的全身治疗。
所有 1 级皮疹患者均对治疗有反应，其中 4/9 名患者在治疗开始后 2 周内皮损完全消退。11 名 2 级皮疹患者中，有 5 名患者红斑和脓疱的改善超过 50%，1 名患者皮损完全消退。2 名患者对治疗无反应，但改用甲硝唑 1%乳膏后症状明显改善。未记录到任何副作用。
我们的病例系列研究表明，吡美莫司乳膏可能是治疗 EGFRIs 相关脓疱性疹的一种有效且安全的方法。
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