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抗肿瘤治疗中分子靶向药物引起的痤疮样疹:综述。

Acneiform eruption induced by molecularly targeted agents in antineoplastic therapy: A review.

机构信息

Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

J Cosmet Dermatol. 2023 Aug;22(8):2150-2157. doi: 10.1111/jocd.15704. Epub 2023 Mar 16.

Abstract

BACKGROUND

Various biologic agents targeting specific molecules present new treatment options for various tumors. Acneiform eruption is a very common skin reaction to these agents. Although not life-threatening, acneiform eruption can affect patients' emotional and social lives. In very exceptional cases, it can lead to cancer therapy interruption.

AIMS

The aim of this study was to review the incidence rate, clinical characteristics, pathogenesis, and current management of acneiform eruption induced by molecularly targeted agents.

METHODS

This review was carried out through PubMed, Embase, and Cochrane searching terms 'acneiform eruption', 'papulopustular eruption' or 'acne-like rash' and 'skin toxicity', 'cutaneous toxicity', 'skin reactions', 'dermatological toxicities', 'target therapy,' or 'drug therapy'.

RESULTS

Of the 73 articles matched our search terms, 61 were original articles and 12 were case reports or case series. Acneiform eruption is most commonly observed in patients treated with epidermal growth factor receptor inhibitors and mitogen-activated protein kinase inhibitors. Typical lesions consist of erythematous papules and pustules without comedones, accompanying with burning, pruritus, or xerosis. The pathogenesis involves inflammation and abnormalities of the follicular epithelium, where a disorder in EGFR signaling plays a key role. The treatment of acneiform eruption depends on the severity of the rash.

CONCLUSIONS

Early recognition and effective management of this cutaneous adverse reaction can prevent unnecessary reduction and discontinuation of drug use and improve patient survival and quality of life. Close collaboration between oncologists and dermatologists is important to optimize therapy and improve patient survival.

摘要

背景

针对特定分子的各种生物制剂为各种肿瘤提供了新的治疗选择。痤疮样疹是这些药物非常常见的皮肤反应。虽然不会危及生命,但痤疮样疹会影响患者的情绪和社交生活。在极少数情况下,它会导致癌症治疗中断。

目的

本研究旨在回顾分子靶向药物引起的痤疮样疹的发生率、临床特征、发病机制和当前治疗方法。

方法

通过 PubMed、Embase 和 Cochrane 搜索术语“痤疮样疹”、“丘疹脓疱疹”或“痤疮样皮疹”和“皮肤毒性”、“皮肤毒性”、“皮肤反应”、“皮肤毒性”、“靶向治疗”或“药物治疗”,对文献进行回顾。

结果

在符合我们搜索条件的 73 篇文章中,有 61 篇是原始文章,12 篇是病例报告或病例系列。痤疮样疹最常见于接受表皮生长因子受体抑制剂和丝裂原活化蛋白激酶抑制剂治疗的患者。典型病变包括无粉刺的红斑丘疹和脓疱,伴有灼热、瘙痒或干燥。发病机制涉及炎症和毛囊上皮异常,其中 EGFR 信号异常起着关键作用。痤疮样疹的治疗取决于皮疹的严重程度。

结论

早期识别和有效管理这种皮肤不良反应可以防止不必要的减少和停止药物使用,并提高患者的生存率和生活质量。肿瘤学家和皮肤科医生之间的密切合作对于优化治疗和提高患者生存率非常重要。

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