Dermatological adverse effects in a cancer patient treated with an EGFR inhibitor. Case report and literature review

Abstract

Introduction. Epidermal growth factor receptor inhibitors (EGFR inhibitors) are used for treatment of advanced malignant tumours associated with EGFR overexpression. In over 50% of treated patients dermatological adverse effects are observed, occurring in form of the PRIDE syndrome (papulopustules and/or paronychia, regulatory abnormalities of hair growth, itching and dryness due to epidermal growth factor receptor inhibitors). Objective. The presented case ilustrates cutaneous adverse events of EGFR inhibitors, an increasing problem in modern medicine. Case report. A 51-year old man treated with panitumumab for advanced stage of rectal cancer was admitted to the hospital because of a papulopustular rash. A specimen of skin was collected for histopathological analysis and revealed an acne-like rash, typical for EGFR inhibitors. Conclusions. EGFR inhibitors are a common cause of cutaneous adverse events. Early identification and tretment of these lesions may decrease the risk of adverse-dependent change in oncological threapy. streszCzenie Wprowadzenie. Inhibitory receptora naskórkowego czynnika wzrostu (EGFR) stosowane są w leczeniu zaawansowanych nowotworów złośliwych, w których stwierdza się nadekspresję EGFR. W trakcie terapii u ponad 50% pacjentów obserwuje się skórne objawy niepożądane występujące w postaci zespołu PRIDE (papulopustules and/or paronychia, regulatory abnormalities of hair growth, itching and dryness due to epidermal growth factor receptor inhibitors). Cel pracy. Przypadek przedstawiono ze względu na coraz częstsze stosowanie inhibitorów EGFR we współczesnej medycynie. Case report/Opis przypadku dermatological adverse effects in a cancer patient treated with an egFr inhibitor. Case report and literature review skórne objawy niepożądane u pacjenta onkologicznego leczonego inhibitorem egFr. opis przypadku i przegląd piśmiennictwa Magdalena korzycka 1 , agnieszka j. osmola-Mańkowska 2 , Monika bowszyc-dmochowska 3 , ryszard W. Żaba 4 , zygmunt adamski 2

Manejo de reações adversas dermatológicas em pacientes submetidos à terapia quimioterápica antineoplásica

“…Os Inibidores do Receptor do fator de crescimento epidérmico são glicoproteínas transmembrana expressas, normalmente, em diversos tecidos humanos e estão envolvidas no controle do crescimento e da proliferação celular (RODARTE et al, 2009). A utilização de medicamentos desta classe induz ao aparecimento de efeitos adversos dermatológicos em mais de 50% dos pacientes tratados, ocorrendo papulopústulas (infecção de pele que secreta pus) e/ou paroníquia (infecção da pele que rodeia a unha), anormalidades do crescimento do cabelo, prurido e ressecamento da pele (KORZYCKA et al, 2018). Estes efeitos adversos são derivados da inibição da expressão e ativação do EGFR nos queratinócitos basais e na bainha radicular externa dos folículos capilares, causando ruptura mecânica do folículo piloso, gerando hiperqueratose e obstrução folicular.…”