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Dermopathy associated with cetuximab and panitumumab: investigation of the usefulness of moisturizers in its management

Authors Watanabe S, Nakamura M, Takahashi H, Hara M, Ijichi K, Kawakita D, Morita A

Received 1 May 2017

Accepted for publication 21 June 2017

Published 11 September 2017 Volume 2017:10 Pages 353—361

DOI https://doi.org/10.2147/CCID.S140796

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Jeffrey Weinberg


Shoichi Watanabe,1 Motoki Nakamura,1 Hiroki Takahashi,2 Masayasu Hara,2 Kei Ijichi,3 Daisuke Kawakita,3 Akimichi Morita1

1Department of Geriatric and Environmental Dermatology, 2Department of Gastroenterological Surgery, 3Department of Neuro-otolaryngology, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

Aims:
Limited data regarding the objective evaluation of skin exsiccation caused by epidermal growth factor receptor (EGFR) inhibitors exist. Objective indices were applied to evaluate the usefulness of a moisturizer against skin exsiccation associated with the use of EGFR inhibitors in cancer patients.
Patients and methods: Patients with either colorectal or head and neck cancer treated with either cetuximab or panitumumab were randomly assigned 1:2 to the prophylactic-treatment arm, where participants received prophylactical moisturizer treatment (heparinoid preparation, Hirudoid®), or to the symptomatic-treatment arm, where moisturizer was applied after the onset of cutaneous symptoms. Patients were observed for 6 weeks after the start of the administration of EGFR inhibitor.
Results:
A total of 15 patients were included and assessed: 6 in the prophylactic treatment group and 9 in the symptomatic treatment group. We evaluated the effect of EGFR inhibitors on the physiologic function of the skin. Administration of EGFR inhibitors resulted in a continued reduction in the moisture content of the horny layer and a decrease in cutaneous sebum levels. Skin observation revealed frequent development of an acneiform rash and significantly higher exsiccation and exfoliation scores. Administration of EGFR inhibitor was associated with a decrease in the horny layer moisture content and lower cutaneous sebum levels in the symptomatic treatment group. In contrast, levels of both the indicators were increased in the prophylactic treatment group. Moreover, the EGFR inhibitor-associated increase in exsiccation and exfoliation scores were minimized in the prophylactic treatment group relative to the symptomatic treatment group.
Conclusion: Application of a moisturizer is effective against dry skin induced by the administration of an EGFR inhibitor.

Keywords: EGFR inhibitor, moisturizer, colorectal cancer, head and neck cancer, prophylactical moisturizer treatment, heparinoid preparation, skin exsiccation

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