Dermatologic Infections in Cancer Patients

Abstract

Dermatologic infections are among the most commonly experienced complications of cancer and anti-cancer therapy. Alterations in host immune function secondary to the underlying malignant process and/or its treatment have been linked to an increase in the risk of infections. The skin and its appendages (i.e., hair and nails) represent the first line of defense against infectious microorganism; its dysfunction as a physical barrier and an immunologic organ in cancer patients leads to an increased susceptibility to infectious organisms. Moreover, a cancer patient's vulnerable state facilitates dissemination of infections to other sites, secondarily involving the skin. This chapter delineates dermatologic infections that are unique to cancer patients as a result of their underlying malignancies and associated comorbidities as well as those resulting from antineoplastic therapies.

Inflammatory dermatoses, infections, and drug eruptions are the most common skin conditions in hospitalized cancer patients

“…Hematologic cancer patients, who often undergo intense treatment regimens including induction chemotherapy, stem cell transplants, and prophylactic antibiotics, are prone to skin infections and dAEs due to their immunocompromised state and exposure to high numbers of systemic therapies. 30 These results suggest that this group of patients may need dermatologic intervention to promptly diagnose skin conditions that may arise during their hospital stay.…”

Local bacteria affect the efficacy of chemotherapeutic drugs

“…an infectious focus) in different settings resulting in in situ biotransformation. Although bacterial infections do not occur frequently, they are by far not clinically irrelevant: for example, infections of the skin are common 42 and could induce local skin toxicity if they came in contact with a drug that can be activated to a more toxic form, infections of the stomach by H. pylori are common 43 and can result in the breakdown of L-DOPA (used to treat Parkinson’s disease) affecting its bioavailability 44 ; monomicrobial or polymicrobial infections of tissues can arise from blood or solid tumours 44 ; bacteraemia due to solid tumours can also present itself in cancer patients 45 and infections of pleural effusions are not uncommon in thoracic disease of neoplastic origin 46 . Chemotherapy itself has also been associated with increased bacterial infection 47 .…”

Skin Complications Associated With Pediatric Central Venous Access Devices: Prevalence, Incidence, and Risk

“…Systemic skin complications, including infections and graft versus host disorder, are a known consequence of many anticancer therapies and stem cell transplantation (Gandhi, Brieva, & Lacouture, 2014). Young age, poor nutritional status, preexisting skin conditions (e.g., eczema), and underlying comorbidities also reduces skin health and places patients at risk for further skin complications (Curley et al, 2018; McNichol, Lund, Rosen, & Gray, 2013).…”