Topical aloe vera for the treatment of cetuximab-related acneiform rash in colorectal cancer: A case report

Abstract

<jats:sec><jats:title>Introduction</jats:title><jats:p> Colorectal cancer is one of the most common cancers in the world. Cetuximab is an epidermal growth factor receptor (EGFR) inhibitor which provides survival benefit when combined with chemotherapy in RAS wild type metastatic colorectal cancer. Cutaneous toxicities associated with cetuximab have a significant impact on patient quality of life, treatment continuation and healthcare resource utilization. </jats:p></jats:sec><jats:sec><jats:title>Case report</jats:title><jats:p> A 60-year-old male patient presented with fatigue, weight loss and abdominal pain. Two closely located malignant polypoid lesions were detected in the sigmoid colon, and pathological examination revealed colonic adenocarcinoma. Management and outcome: Thorax, abdominal and pelvic computed tomography showed metastases. FOLFOX chemotherapy and cetuximab were started. The patient developed acneiform rash firstly in his face, although prophylactic vitamin K1 0.1% containing cream was given. He was given mild potency topical corticosteroid and doxycycline. The lesions progressed to his front and back body. He did not want to use topical vitamin K1 cream, topical steroid and doxycycline tablets. Instead, he wanted to use aloe vera extract which he produced from the leaves of the plant. Patient’s lesions were regressed significantly. </jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p> The most common and earliest skin toxicity is acneiform rash which affects 60 to 80% of the patients. In this case, cetuximab-related severe acneiform rash was effectively treated by topical aloe vera. Topical aloe vera may be used in the management of cetuximab-related cutaneous toxicities without any side effect. </jats:p></jats:sec>

Therapeutic Effect of <i>Aloe vera</i> on Croton Oil Induced Hemorrhoids

“…Several studies have investigated the biological and toxicological properties of Aloe Vera and have proved to have anti-diabetic activity 22 , cell proliferation property, angiogenesis, immune-modulatory, antimicrobial 23 , anti-cancer properties 24 and various skin diseases 25 . An acute toxicity study done on Aloe Vera gel dosed water showed no signs of toxicity at 500mg/kg 26 .…”

A Commentary on the “Duration of Oral Antibiotics Administration for Cetuximab-Induced Acneiform Eruption”

“…Many other treatment and prophylactic measures exist; nevertheless, further research is required as they currently do not possess enough data that would support their efficacy in practice. These include topical aloe vera gel, topical vitamin K1 (phytonadione), Huang-Lia Jie-Du decoction, epidermal growth factor-containing topical creams, and dapsone [4, 5, 12, 13]. In addition to the lack of sufficient evidence to support them, some of them, such as vitamin K1 and retinoids, have been shown to have undesirable side-effects [4].…”