Pathobiology of Cancer Regimen-Related Toxicities by Stephen T. Sonis & Dorothy M. Keefe

Author:Stephen T. Sonis & Dorothy M. Keefe
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

EGFRI-Induced Xerosis and Pruritus

Skin dryness (xerosis) is a frequently observed toxicity in patients receiving EGFRI, which can affect up to 35% of patients [6]. This adverse event is subacute/chronic in nature, manifesting after several weeks of therapy and typically subsequent to the appearance of the rash [4, 6]. Up to 100% of patients treated with EGFRI for greater than 6 months develop xerosis [26]. The involvement is not limited to the areas of the eruption and extends to affect larger body surface areas [27]. Associated with pruritus and characterized by fine superficial diffuse scaling, it can progress to severe xerosis, ichthyosis-like changes, and asteatotic dermatitis [28]. Further ­disruption of the epidermis leads to physical breakdown of skin and painful fissures, which tend to form on the distal finger tufts, dorsal surface of interphalangeal joints, and nail folds (Fig. 8.2) [4, 5]. However, any region can be affected, including palms and trunk, with formation of deep and long fissures [22].

Fig. 8.2Dry skin (xerosis), with fissures affecting fingertips, associated with pain and limiting activities of daily living

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