Phytomenadione pre‐treatment in EGFR inhibitor‐induced folliculitis

Abstract

Topical pre-treatment with phytomenadione cream might become useful in epidermal growth factor inhibitor-associated acneiform eruptions.

Pilot Clinical Trial on the Efficacy of Prophylactic Use of Vitamin K1–Based Cream (Vigorskin) to Prevent Cetuximab-Induced Skin Rash in Patients With Metastatic Colorectal Cancer

“…Overall, the maximum grade of skin toxicity during the first 8 weeks of treatment, according to CTCAE version 3.0, was grade 33 20, H&N, CRC Cet, Pani K 1 , 0.05%-0.1% P 75% grade 1, 25% grade 2; no effects on coagulation Ocvirk and Cencelj (2010) 34 4, CRC Cet K 1 , 0.1% P 3 moderate rash, 1 mild rash; rapid Ocvirk (2009), ASCO 35 69, CRC Cet K 1 , 0.1% T Median time to improvement 8 days; downstaging of rash by 1 grade by 18 days Pinto (2011), ASCO-GI 36 33, H&N, CRC, EG Cet, Pani K 1 , 0.1% T Decrease in skin rash in 37%; good symptom control in 69% Radovics (2010) 37 120, H&N, CRC Cet Vitamin K Prevents Cetuximab-Induced Rash 0, grade 1, grade 2, and grade 3 in, respectively, 6 (15%), 18 (45%), 10 (25%), and 6 (15%) of the patients; no grade 4 CISR has been reported. Overall, 4 patients reported itching, 3 of them having grade 3 skin rash.…”

Antibiotic prophylaxis for skin toxicity induced by antiepidermal growth factor receptor agents: a systematic review and meta-analysis

“…Among them, vitamin K1 is used to prevent disruption of the balance between proliferation and differentiation, thinning of the epidermis, immune reactions and inflammatory reactions leading to folliculitis. Currently, there is no major rationale for using vitamin K1 as a pre‐emptive measure, as it provided only a minimal or insignificant benefit in reducing skin rash due to anti‐EGFR agents …”

Management of Skin Reactions During Cetuximab Treatment in Association With Chemotherapy or Radiotherapy

“…These include vitamin K, and in particular vitamin K1 (fillochinone) and K3 (menadione). [27][28][29][30][31][32][33][34][35]52,53 Early data on antibiotic prophylaxis also indicate a positive role of tetracyclines. [37][38][39][40][41] The updated Expert Opinion detailed in this article represents the second Italian consensus positions derived from best clinical practices and from the available scientific literature on the treatment of anti-EGFR skin reactions.…”