Skin Toxicities During Colorectal Cancer Chemotherapy: Incidence and Pearls of Treatment in Our Experience.
INTRODUCTION
Medical treatment of advanced colorectal cancer is effective in prolonging the survival of patients. The aim of this study was to describe the most common skin toxicities that occur in those patients, analyzing the association between the type of reaction and the different chemotherapeutic drugs; and to evaluate the importance of an outpatient dermatologic service to improve quality of life.


PATIENTS AND METHODS
Seventy-two patients with skin reactions from advanced colorectal cancer chemotherapy were included. Each patient underwent physical examination and digital photographic imaging, and completed a quality-of-life questionnaire (Dermatology Life Quality Index [DLQI]).


RESULTS
Papulopustular rash was the most common side effect observed. It was statistically associated with EGFRi + irinotecan, EGFRi + FOLFOX, and EGFRi. Xerosis occurred in 50% of patients during EGFRi therapy. Periungual pyogenic granuloma-like lesions occurred in 30% of patients during EGFRi therapy. Our data underline a statistically significant association between capecitabine, FOLFOX + EGFRi, FOLFIFI + EGFRi, and hand-foot syndrome (P < .001). Because none of patients treated with EGFRi alone developed this kind of reaction, we suppose that it is associated with the use of 5-fluorouracil. Fifty percent of patients receiving anti-epidermal growth factor receptor (EGFR) therapy developed trichomegaly. These data underline a statistically significant association between these reactions and this specific drug.


CONCLUSION
A dermatologic visit is useful, both for the correct diagnosis of and for the adequate therapy of chemotherapy side effects. The prevention and treatment of these toxicities are important, not only to improve quality of life but also to avoid unnecessary dose reduction or interruption, which can have a negative effect on treatment outcome.
['Panariello|Luigia|L|', 'Donnarumma|Marianna|M|', 'Iaffaioli|Rosario Vincenzo|RV|', 'Chiodini|Paolo|P|', 'Annunziata|Maria Carmela|MC|', 'Peduto|Tiziana|T|', 'Fabbrocini|Gabriella|G|']
D000279:Administration, Cutaneous D000368:Aged D000900:Anti-Bacterial Agents D000971:Antineoplastic Combined Chemotherapy Protocols D015179:Colorectal Neoplasms D003875:Drug Eruptions D004643:Emollients D005260:Female D005938:Glucocorticoids D006633:Histamine Antagonists D006801:Humans D015994:Incidence D008297:Male D008875:Middle Aged D011788:Quality of Life D012720:Severity of Illness Index D011795:Surveys and Questionnaires
Skin reactions Papulopustular rash Xerosis Trichomegaly EGFR inhibitors