Choosing between isotretinoin and acitretin for epidermal growth factor receptor inhibitor and small molecule tyrosine kinase inhibitor acneiform eruptions

Costello, Collin M.; Hill, Hannah; Brumfiel, Caitlin M.; Yang, Yul W.; Swanson, David L.

doi:10.1016/j.jaad.2020.09.090

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…6 However, refractory cases to such treatment remain. For refractory cases, oral isotretinoin can be considered an alternative treatment option, 18,36,47 the majority can get a moderate to significant improvement after using retinoids, 48 although isotretinoin may aggravate skin xerosis and photosensitivity in some individuals. It is suggested that patients experiencing cutaneous toxicity of grade 2…”

Section: Treatmentmentioning

confidence: 99%

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

Cheng

Wang

2023

J of Cosmetic Dermatology

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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.

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Section: Treatmentmentioning

confidence: 99%

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

Cheng

Wang

2023

J of Cosmetic Dermatology

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“…In March 2021 was published a retrospective study by Costello CM et al on six patients with EGFR inhibitor/small molecule tyrosine kinase inhibitor acneiform eruption of which four were treated with isotretinoin (10 mg to 60 mg daily), one with acitretin (10 mg to 25 mg daily) and one with isotretinoin and, subsequently, with acitretin. Results showed that isotretinoin led to a greater clinical improvement compared to acitretin with respect to acneiform eruptions [ 128 ]. These results are in accordance with those of Andrews ED et al from 2020, who also reported that patients with acneiform eruption due to EGFR inhibitors taking acitretin or isotretinoin within one month maintained a stable Grade 1 dermatitis without dose reduction of oncologic therapy [ 129 ].…”

Section: Alternatives To Antibiotic Treatmentmentioning

confidence: 99%

The Impact of Long-Term Antibiotic Therapy of Cutaneous Adverse Reactions to EGFR Inhibitors in Colorectal Cancer Patients

Mihai

Ion

Giurcăneanu

et al. 2021

JCM

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Colorectal cancer (CRC) is an important public health issue, in terms of incidence and mortality, with approximately 1.8 million new cases reported worldwide in 2018. Advancements in understanding pathophysiological key steps in CRC tumorigenesis have led to the development of new targeted therapies such as those based on epidermal growth factor receptor inhibitors (EGFR inhibitors). The cutaneous adverse reactions induced by EGFR inhibitors, particularly papulopustular rash, often require long-term antibiotic treatment with tetracycline agents (mostly minocycline and doxycycline). However, this raises several issues of concern: possible occurrence of gut dysbiosis in already vulnerable CRC patients, selection of highly antibiotic resistant and/or virulent clones, development of adverse reactions related to tetracyclines, interference of antibiotics with the response to oncologic therapy, with a negative impact on disease prognosis etc. In the context of scarce information regarding these issues and controversial opinions regarding the role of tetracyclines in patients under EGFR inhibitors, our aim was to perform a thorough literature review and discuss the main challenges raised by long-term use of tetracyclines in advanced CRC patients receiving this targeted therapy.

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“…However, 10% of patients may experience a more severe reaction [5] that may become refractory to the use of tetracyclines as inour case [1,2]. In these cases, isotretinoin should be considered an effective and safe alternative to be used, as it permits continuation of the antineoplastic treatment, a key point for cancer patients [3,6].…”

Section: Severe Acneiform Eruption Secondary To Cetuximab Successfully Treated With Isotretinoin Case Presentationmentioning

confidence: 99%

Severe Acneiform Eruption Secondary to Cetuximab Successfully Treated with Isotretinoin

Montes‐Torres¹,

Camarero-Mulas²

2021

Mathews Journal of Dermatology

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Choosing between isotretinoin and acitretin for epidermal growth factor receptor inhibitor and small molecule tyrosine kinase inhibitor acneiform eruptions

Cited by 5 publications

References 5 publications

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

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

The Impact of Long-Term Antibiotic Therapy of Cutaneous Adverse Reactions to EGFR Inhibitors in Colorectal Cancer Patients

Severe Acneiform Eruption Secondary to Cetuximab Successfully Treated with Isotretinoin

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