Dry Skin Rash
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Targeted therapy and immunotherapy are specific types of cancer medications. Like other cancer treatments, they often cause side effects. There are some similarities and differences in side effects between these types of cancer medications compared to chemotherapy drugs. This information explains changes to the skin, included related changes to hair, nails, and eyes, that can happen during treatment with targeted therapy or immunotherapy. Let your health care team know about any symptoms you experience. This includes any new symptoms or a change in symptoms. Managing skin reactions and other cancer side effects is an important part of your medical care and treatment. This type of care is called palliative care or supportive care.
Targeted therapy is a treatment that targets the specific genes, proteins, or the tissue environment that contributes to cancer growth and development. Some targeted therapies can cause specific side effects to the skin, hair, and nails. These side effects are caused by the effect of medications on the healthy growth of these tissues.
Drugs that target EGFR. This common type of targeted therapy focuses on a molecule known as epidermal growth factor receptor (EGFR). EGFR fuels the growth of cancer cells. It also plays a role in the normal growth of the skin, hair, and nails. This means rashes and changes to the hair and nails may occur during treatment with these drugs. Most people taking drugs that target EGFR develop a rash on their face and upper body. It usually happens within the first few weeks of taking these medications. You may notice redness or a warm sensation like a sunburn before the rash begins. After several days, pimples and pus bumps appear, and the surrounding skin feels slightly tender. Rashes are usually mild to moderate. But some people have severe rashes that cause major physical and cosmetic discomfort. The skin can also become very dry and itchy, interfering with daily activities and sleep. Skin on the fingertips may crack. Skin may also become more sensitive to sunlight. A lot of scratching can result in breaks in the skin. These openings make the skin more prone to infections. Inflammation around the nails can make grooming, dressing, and other activities painful or difficult.
Drugs that target VEGF. Another type of targeted therapy that may cause skin problems includes drugs that block a protein called vascular endothelial growth factor (VEGF). This protein helps make new blood vessels. This group of drugs may also be called angiogenesis inhibitors because they block the formation of blood vessels. When these drugs affect the blood vessels in the hands and feet, they can cause skin problems.
Your health care team can help you manage these side effects so treatment can continue. Managing these side effects can also help avoid major changes to your skin, hair, and nails. It is important to note that the skin side effects linked with these drugs are not allergic reactions or infections.
Most skin reactions to immunotherapy are caused by a certain class of drugs called immune checkpoint inhibitors. These drugs target molecules such as PD-1, PD-L1, and CTLA-4. Examples of these medications include ipilimumab, nivolumab, and pembrolizumab, among others.
Skin reactions can occur anywhere on the body, even in the mucus membranes. Affected areas of skin may be small or cover large areas of the body. Treatment may include moisturizing skin creams, antihistamine medications, and/or steroids. Depending on the severity of the side effect, your doctor may pause or permanently stop treatment with the immune checkpoint inhibitor.
If you get care for your skin condition at a place not familiar with your cancer treatment, be sure to tell the health care team there that you are on immunotherapy. For instance, you may decide to go to an emergency room or see a dermatologist. If possible, give them the name of the drug, your oncologist, and cancer center where you receive immunotherapy. Keep this information in your wallet or phone in case you need it quickly. Download and print Cancer.Net's foldable wallet card to organize this information.
Rashes, dry skin, and nail and hair reactions are rarely severe. But they can cause major discomfort. Patients may even want to stop cancer treatment because of these reactions. It is important to talk with your health care team about what to expect. Also tell your doctor as soon as you start feeling or seeing any side effects. There are early and effective treatments for these reactions.
Before you begin treatment, talk with your health care team about the side effects. If you have existing skin problems before starting immunotherapy, you may wish to talk with a dermatologist. A dermatologist is a doctor who specializes in skin conditions. Ask what to do if a rash or other problems appear. This may include how to get a prescription filled or the best way to see the doctor.
At the first sign of a reaction, tell your doctor or a dermatologist familiar with these reactions. Signs of a reaction include a warm or burning sensation, itching, bumps or blisters, nail cracks, or dry skin.
Protecting your skin from the sun may help prevent skin problems while you are receiving immunotherapy. Use a sunscreen with a sun protection factor (SPF) of at least 15. If the sunscreen causes a burning sensation, you can try sunscreens that contain zinc oxide or titanium dioxide. Remember to use enough sunscreen. Apply more than half a teaspoon of sunscreen to each arm, your face, and your neck. Apply just over 1 teaspoon to your chest and abdomen, your back, and each leg. Re-apply sunscreen every 2 hours when outdoors, or more often if sweating or swimming. Use a broad-brimmed hat and sun-protective clothing and avoid being in direct sunlight between 10 AM and 4 PM.
Apply a cream-based moisturizer to all skin within 5 minutes of showering or bathing. Use hypoallergenic moisturizers that do not have perfumes or preservatives, such as Vanicream, Aveeno, CeraVe, Cetaphil, and Eucerin.
Your doctor may prescribe medicated skin creams for a rash. If the rash is severe or covers a large area of the body, you may need oral corticosteroids, such as prednisone or dexamethasone (available as generic drugs).
Download ASCO's free Rash fact sheet. This 1-page printable PDF gives an introduction to rashes, including symptoms, how it is treated, ways to manage discomfort, words to know, and questions to ask the health care team. It also includes a tracking sheet to record when the rash started and where and how it appears.
Following the same skin care routine year-round may not work so well when the humidity drops. Without a change in your skin care, dry air can make fine lines and wrinkles more noticeable. Dry, itchy skin can flake, crack, and even bleed.
Stop baths and showers from worsening dry skin. When the humidity drops or your skin feels dry, be sure to:Close the bathroom door.Use warm rather than hot water.Limit your time in the shower or bath to 5 or 10 minutes.Wash with a gentle, fragrance-free cleanser.Apply enough cleanser to remove dirt and oil, avoid using so much that you see a thick lather.Blot your skin gently dry with a towel.Slather on the moisturizer immediately after drying your skin.
Apply moisturizer immediately after washing. Ointments, creams, and lotions (moisturizers) work by trapping existing moisture in your skin. To trap this much-needed moisture, you need to apply a moisturizer within few minutes of:Drying off after a shower or bathWashing your face or hands
Use only gentle, fragrance-free skin care products. Some skin care products, such as deodorant soaps, are too harsh for dry, sensitive skin. Dermatologists recommend using products labeled "fragrance-frree."If you see the word "unscented," the product can contain chemicals that neutralize or hide the odors of other ingredients. These chemicals can irritate dry, sensitive skin.
Wear gloves. Our hands are often the first place we notice dry skin. You can reduce dry, raw skin by putting on gloves before you:Go outdoors in winter.Perform tasks that require you to get your hands wet.Get chemicals, greases, and other substances on your hands.
Your skin should start to feel better quickly. If these changes do not bring relief, you may want to see a dermatologist. Very dry skin can require a prescription ointment or cream. Dry skin also can be a sign of a skin condition that needs treatment. A dermatologist can examine your skin and explain what can help reduce your discomfort.
The major side effect associated with cetuximab treatment is skin toxicity, including skin rash, dry skin, hair growth disorders, pruritus, and nail changes [15, 16]. Cutaneous toxicity can severely impact patients' physical, psychological, and social well-being and can lead to treatment discontinuation and dose reduction. Therefore, appropriate management is necessary to allow adequate drug administration and to improve health-related quality of life and outcomes.
The agreement between oncologists and dermatologists in labelling and grading cutaneous lesions is poor, and interobserver inconsistencies are frequent . As a consequence, the current terminology remains variable, and even the clinical features corresponding to the same terms, such as rash or acneiform rash or acnelike rash, are probably different across the trials.
Cold, dry outdoor air and indoor heating can rob skin of its natural moisture in the winter. Red, crusty, dry patches can be common on a baby's skin, particularly in winter, and cause concern for parents. Such symptoms can be treated, however, and many babies and children do outgrow the dry, itchy skin of atopic dermatitis, also known as eczema. 781b155fdc