Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Dermatology. 2012;225(2):135-40. doi: 10.1159/000342203. Epub 2012 Sep 21.
Epidermal growth factor receptor (EGFR) inhibitors have been used as anticancer agents for the treatment of a variety of solid tumors. Related skin toxicities are the most common adverse effects and occur with all EGFR inhibitors. Several treatment approaches, such as antiseptic soaps, topical and oral antibiotics, and topical and oral corticosteroids, have been reported; however, the responses have been varied. Acneiform eruption induced by EGFR inhibitor treatment results from disturbed normal keratinocyte and hair follicle biology and may therefore benefit from local restoration of EGF pathway.
We treated HaCaT cells with EGFR inhibitor and evaluated the expression of EGFR. After treatment of cells with EGFR inhibitor, EGFR expression was increased in a dose-dependent manner. We hypothesized that newly synthesized EGFR, not inhibited by EGFR inhibitors, may perform their biological action in keratinocytes in the presence of additional EGF. In this study, we therefore treated acneiform eruption patients with topical recombinant human EGF (rhEGF) with institutional review board approval. Here, we report three cases of such eruptions who responded to topical rhEGF.
Topical rhEGF may be an effective treatment option for EGFR inhibitor-induced acneiform eruption.
表皮生长因子受体（EGFR）抑制剂已被用作治疗各种实体瘤的抗癌药物。相关的皮肤毒性是最常见的不良反应，并且发生于所有的 EGFR 抑制剂。已经报道了几种治疗方法，例如抗菌肥皂、局部和口服抗生素以及局部和口服皮质类固醇；然而，反应各不相同。由 EGFR 抑制剂治疗引起的痤疮样疹是由于正常角质形成细胞和毛囊生物学受到干扰所致，因此可能受益于局部 EGF 通路的恢复。
我们用 EGFR 抑制剂处理 HaCaT 细胞并评估 EGFR 的表达。用 EGFR 抑制剂处理细胞后，EGFR 的表达呈剂量依赖性增加。我们假设，新合成的 EGFR 可能在存在额外的 EGF 的情况下在角质形成细胞中发挥其生物学作用，而不受 EGFR 抑制剂的抑制。在这项研究中，我们因此在机构审查委员会的批准下，用局部重组人表皮生长因子（rhEGF）治疗痤疮样疹患者。在这里，我们报告了 3 例对局部 rhEGF 有反应的此类皮疹患者。
局部 rhEGF 可能是 EGFR 抑制剂诱导的痤疮样疹的有效治疗选择。
