Preemptive Management of Dermatologic Toxicities Associated With Epidermal Growth Factor Receptor Inhibitors

Abstract

Epidermal growth factor receptor inhibitors (EGFRIs) are a treatment option for patients diagnosed with advanced-stage gastrointestinal, lung, and head and neck cancers. The most prevalent complications associated with EGFRIs are dermatologic toxicities, which may result in either disruption or discontinuation of treatment and adversely affect patients' quality of life. Nurses play a vital role in educating patients about EGFRI-related dermatologic toxicities; therefore, nurses must continue to educate themselves on the various aspects of EGFRI treatment. An overview of the EGF signaling pathway is provided, and dermatologic toxicities associated with EGFRI treatment are described. A review of several studies evaluating reactive skin treatment regimens also are discussed. Nurses play a critical role in providing patient support. Informing patients about potential EGFRI-related symptoms and dermatologic toxicities will help prepare patients for their course of treatment. In addition, nurses should provide patients with a variety of coping strategies to help manage dermatologic toxicities that will assist in enhancing patients' adherence to EGFRI treatment.

Management of epidermal growth factor receptor tyrosine kinase inhibitor‐related cutaneous and gastrointestinal toxicities

“…If trichomegaly involves the eyelashes, eye irritation and conjunctivitis can occur. [28][29][30] Alopecia associated with EGFR TKI primarily consists of catagen/telogen hair follicles and different inflammatory infiltrates. [24][25][26][27]31 …”

Dermatologic Toxicities from Monoclonal Antibodies and Tyrosine Kinase Inhibitors against EGFR: Pathophysiology and Management

“…Hirsutism is usually characterized by causing hair curling and rigidity, facial hypertrichosis, and trichomegaly. The latter involving the eyelashes can lead to eye irritation and conjunctivitis [41, 43, 44]. …”

Role of systemic antibiotics in preventing epidermal growth factor receptor: Tyrosine kinase inhibitors-induced skin toxicities

“…They occur in more than 50% of patients with Grade 3 or greater severity in 3%–20% of patients receiving these agents. [ 5 6 ] The proper functioning of the EGFR signaling pathway contributes to the normal development and maintenance of the skin (e.g., protection against ultraviolet (UV)-induced damage, wound healing). EGFR is highly expressed in the human skin within keratinocytes, follicular epithelium, sweat and sebaceous glands, and in dermal capillaries.…”

“…[ 2 7 8 ] This results in the thinning of the outermost layers of the epidermis and corneal layers, and subsequent loss of the skin's protective barrier that results in the increased sensitivity to UV radiation damage. [ 6 ]…”