Saraswat Neerja, Sood Aradhana, Kumar Dharmesh, Verma Rajesh, Sushil Kumar
Department of Dermatology, Base Hospital, Delhi Cantt, New Delhi, India.
Department of Dermatology, Base Hospital, Lucknow Cantt, Uttar Pradesh, India.
Indian Dermatol Online J. 2019 May-Jun;10(3):251-255. doi: 10.4103/idoj.IDOJ_325_18.
Epidermal growth factor receptor (EGFR) inhibitors are an extensively utilized class of chemotherapeutic agents which form an integral component of treatment in solid organ malignancies such as non-small-cell lung carcinoma, pancreatic carcinoma, colorectal carcinoma, and head and neck carcinoma. It has two subclasses: epidermal growth factor inhibitors (erlotinib) and monoclonal antibody (cetuximab). A wide array of cutaneous adverse effects has been attributed to this class of drugs, such as papulopustular eruptions, paronychia, xerosis, and changes in hair and nails.
A total of 76 cases of various malignancies on EGFR inhibitors who developed cutaneous side effects while on therapy and reported or referred to us by oncologists from January 2017 to January 2018 were included in the study. All the patients who were on other associated medications or radiotherapy were excluded.
In all, 45 (59.2%) were males and 31 (40.7%) were females. Non-small-cell lung carcinoma was the most common carcinoma in 32 (42.1%) patients, and cetuximab was the most common drug in 29 (38.1%) cases. Papulopustular eruptions were seen in 61 (80.2%) patients, xerosis in 31 (40.7%), mucositis in 6 (7.8%), hair growth problems in 4 (5.6%), and paronychia and pyogenic granuloma in 2 (2.6%) patients each.
Although most of the skin toxicities associated with EGFR inhibitors can be managed conservatively, a critical analysis of the cases that are significantly affected due to these side effects is required in cohesion with the treating oncologist to improve the therapeutic compliance of the drug.
表皮生长因子受体（EGFR）抑制剂是一类广泛应用的化疗药物，是实体器官恶性肿瘤（如非小细胞肺癌、胰腺癌、结直肠癌和头颈癌）治疗的重要组成部分。它有两个亚类：表皮生长因子抑制剂（厄洛替尼）和单克隆抗体（西妥昔单抗）。这类药物会引发多种皮肤不良反应，如丘疹脓疱性皮疹、甲沟炎、皮肤干燥以及毛发和指甲的变化。
本研究纳入了2017年1月至2018年1月期间接受EGFR抑制剂治疗并出现皮肤副作用的76例各种恶性肿瘤患者，这些患者由肿瘤学家报告或转诊至我们这里。所有正在使用其他相关药物或接受放疗的患者均被排除。
总共45例（59.2%）为男性，31例（40.7%）为女性。非小细胞肺癌是最常见的癌症，有32例（42.1%）患者；西妥昔单抗是最常用的药物，有29例（38.1%）患者使用。61例（80.2%）患者出现丘疹脓疱性皮疹，31例（40.7%）出现皮肤干燥，6例（7.8%）出现黏膜炎，4例（5.6%）出现毛发生长问题，2例（2.6%）患者分别出现甲沟炎和化脓性肉芽肿。
虽然大多数与EGFR抑制剂相关的皮肤毒性可以保守处理，但需要与主治肿瘤学家联合对因这些副作用而受到严重影响的病例进行批判性分析，以提高药物的治疗依从性。
