Chanprapaph K, Vachiramon V, Rattanakaemakorn P
Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Rajthevi, Bangkok 10400, Thailand.
Dermatol Res Pract. 2014;2014:734249. doi: 10.1155/2014/734249. Epub 2014 Mar 2.
Epidermal growth factor inhibitors (EGFRI), the first targeted cancer therapy, are currently an essential treatment for many advance-stage epithelial cancers. These agents have the superior ability to target cancers cells and better safety profile compared to conventional chemotherapies. However, cutaneous adverse events are common due to the interference of epidermal growth factor receptor (EGFR) signaling in the skin. Cutaneous toxicities lead to poor compliance, drug cessation, and psychosocial discomfort. This paper summarizes the current knowledge concerning the presentation and management of skin toxicity from EGFRI. The common dermatologic adverse events are papulopustules and xerosis. Less common findings are paronychia, regulatory abnormalities of hair growth, maculopapular rash, mucositis, and postinflammatory hyperpigmentation. Radiation enhances EGFRI rash due to synergistic toxicity. There is a positive correlation between the occurrence and severity of cutaneous adverse effects and tumor response. To date, prophylactic systemic tetracycline and tetracycline class antibiotics have proven to be the most effective treatment regime.
表皮生长因子抑制剂（EGFRI）是第一种靶向癌症治疗药物，目前是许多晚期上皮癌的重要治疗方法。与传统化疗相比，这些药物具有更强的靶向癌细胞能力和更好的安全性。然而，由于表皮生长因子受体（EGFR）信号在皮肤中的干扰，皮肤不良事件很常见。皮肤毒性会导致依从性差、停药和心理社会不适。本文总结了目前关于EGFRI引起的皮肤毒性的表现和管理的知识。常见的皮肤不良事件是丘疹脓疱和皮肤干燥。较少见的表现是甲沟炎、毛发增生调节异常、斑丘疹、粘膜炎和炎症后色素沉着。由于协同毒性，放疗会加重EGFRI皮疹。皮肤不良反应的发生和严重程度与肿瘤反应之间存在正相关。迄今为止，预防性全身使用四环素和四环素类抗生素已被证明是最有效的治疗方案。
