Dermatologic Principles and Practice in Oncology: Conditions of the Skin, Hair, and Nails in Cancer Patients

Cover......Page 1
Title page......Page 5
Copyright page......Page 6
Contents......Page 7
List of Contributors......Page 9
Preface......Page 12
1: Dermatology and Oncology......Page 13
Dermatologic health in cancer patients and survivors......Page 15
Health-related quality of life......Page 16
References......Page 17
Appendix 1.1 Anticancer agents and associated adverse events affecting the skin, mucosa, hair, and nails. Based on data from Litt JZ, 2009 [8].......Page 19
Evolution of anticancer therapeutics......Page 29
Spectrum of dermatologic adverse events stemming from conventional cytotoxic chemotherapy agents......Page 31
Emergence of supportive oncodermatology and future directions......Page 32
References......Page 33
Dermal–epidermal junction......Page 36
Subcutaneous tissue......Page 37
Nails......Page 38
Papule......Page 39
Nodule......Page 40
Ulcer......Page 41
Abscess......Page 42
Shape, configuration, arrangement, and distribution of lesions......Page 43
Conclusions......Page 44
Exanthematous eruptions......Page 45
Pustular eruptions (acute generalized exanthematous pustulosis)......Page 46
Drug-induced vasculitis......Page 47
Step 1: Recognizing the morphology......Page 48
Step 2: Associated symptoms and systemic involvement......Page 49
Step 3: Histopathologic assessment......Page 53
References......Page 55
Common Terminology Criteria for  Adverse Events......Page 59
Refined grading to correlate with clinical management......Page 60
Alopecia......Page 61
Bullous dermatitis......Page 62
Rash pustular......Page 64
CTCAE vs. MESTT......Page 65
References......Page 66
Distress among dermatologic samples......Page 72
Dermatologic AEs from cancer treatment......Page 74
Risk factors for distress......Page 75
Psychosocial interventions in oncodermatology......Page 76
References......Page 78
Squamous cell carcinoma......Page 81
Interface (lichenoid) dermatitis......Page 82
Superficial or superficial and deep perivascular lymphohistiocytic inflammation......Page 84
References......Page 85
2: Cancer-Related Dermatologic Disorders......Page 87
Skin changes from hormone-secreting tumors......Page 89
Proliferative and inflammatory paraneoplastic dermatoses......Page 90
Gardner syndrome......Page 94
Howel–Evans syndrome......Page 95
References......Page 96
3: Dermatologic Conditions During Cancer Therapy......Page 99
Mucosal injury attributable to cytotoxic therapy......Page 101
Clinical features and course of mucositis......Page 102
Variability between mucositis scales......Page 103
Pathobiology of mucositis......Page 104
Risk factors for mucositis......Page 106
Status of the development of therapies for mucositis......Page 107
Small molecules and antibodies......Page 108
References......Page 109
Basic hair anatomy and function......Page 112
Anagen effluvium......Page 113
Abnormal hair growth......Page 115
Permanent chemotherapy-induced alopecia......Page 116
Grading scales utilized for determining degree of hair loss or regrowth......Page 117
Prevention of hair loss......Page 120
References......Page 122
Classic cytotoxic drugs......Page 127
Nail fold involvement......Page 128
Classification......Page 130
References......Page 132
Therapy......Page 134
Clinical findings......Page 135
General principles......Page 136
Topical treatments......Page 137
Systemic treatments......Page 138
References......Page 140
Pharmacologic interventions......Page 143
Conclusions and recommendations......Page 149
References......Page 151
4: Skin Toxicities to Chemotherapy......Page 157
Mustargen (mechlorethamine)......Page 159
Cyclophosphamide......Page 160
ThioTEPA......Page 161
Carmustine (bischloroethylnitrosourea)......Page 164
Dacarbazine......Page 165
References......Page 166
Pemetrexed......Page 172
Capecitabine......Page 173
Gemcitabine......Page 175
Mercaptopurine......Page 176
References......Page 177
Anthracyclines: Doxorubicin, liposomal doxorubicin, epirubicin and idarubicin......Page 182
Etoposide and teniposide......Page 183
Alopecia......Page 184
Hand-foot syndrome......Page 185
Nail changes......Page 186
References......Page 187
Papulopustular (acneiform) rash......Page 196
Xerosis and pruritus......Page 200
Mucosal toxicities......Page 202
Nail and periungual involvement......Page 203
References......Page 205
Drugs, indications, and mechanisms of action......Page 208
Hand-foot skin reaction......Page 211
Hair modifications......Page 212
AEs related specifically to sorafenib......Page 213
Skin manifestations......Page 214
References......Page 215
Taxanes......Page 220
Clinical features......Page 221
Treatment of choice and prognosis......Page 223
Estramustine phosphate sodium......Page 224
References......Page 225
Romidepsin......Page 227
Bortezomib......Page 228
Arsenic trioxide......Page 229
Bexarotene, all-trans retinoic acid or tretinoin, and alitretinoin......Page 231
References......Page 233
Allergic reactions......Page 236
Bleomycin......Page 237
Raynaud phenomenon and gangrene......Page 238
Thalidomide......Page 239
Lenalidomide......Page 240
References......Page 241
Appendix 21.1 Incidence of dermatologic adverse events to miscellaneous agents (l-asparaginase, bleomycin, thalidomide, lenalidomide).......Page 243
Dermatologic AEs to IFN-α......Page 245
Interleukins......Page 246
Dermatologic AEs to IL-2......Page 247
References......Page 248
Appendix 22.1 Incidence of dermatologic adverse events to biotherapies (interferon-a2a, interferon-a2b, interleukin 2).......Page 251
Clinical manifestations and mechanisms......Page 253
AEs caused by the function of the mAb......Page 255
Conclusions......Page 257
References......Page 258
Selective estrogen receptor modulators......Page 260
Estrogen receptor downregulators......Page 261
Aromatase inhibitors......Page 262
Antiandrogens......Page 263
Progestational agents......Page 264
References......Page 265
Granulocyte colony-stimulating factors and granulocyte–macrophage colony-stimulating factors......Page 269
Dermatologic AEs......Page 270
Low molecular weight heparin......Page 272
Warfarin......Page 273
References......Page 274
Clinical features and pathophysiology......Page 276
Classification of acute radiation-induced dermatitis......Page 277
Patient factors......Page 278
Treatment-related factors......Page 279
Results......Page 281
Dexpanthenol......Page 282
Conclusions......Page 283
References......Page 284
Preparative regimens......Page 293
Early cutaneous complications......Page 294
Acute graft versus host disease......Page 295
Chronic graft versus host disease......Page 299
References......Page 302
Risk factors......Page 307
Clinical features......Page 308
Treatment......Page 309
Antidotes in chemotherapeutic drug extravasations......Page 310
References......Page 311
Mechlorethamine......Page 313
Fluorouracil......Page 315
Alitretinoin......Page 316
Imiquimod......Page 317
Corticosteroids......Page 318
Conclusions......Page 319
References......Page 320
Stevens–Johnson syndrome and toxic epidermal necrolysis......Page 322
Hypersensitivity reactions......Page 323
Etoposide and teniposide......Page 324
Drug rash with eosinophilia and systemic symptoms......Page 325
References......Page 326
Gram-positive organisms......Page 331
Gram-negative bacteria......Page 333
Primary superficial dermatophyte and yeast infections......Page 334
Primary opportunistic invasive nondermatophyte infections......Page 335
Invasive mold infections......Page 336
Varicella zoster virus......Page 338
Parasitic infections......Page 339
Infectious sequelae of radiotherapy......Page 340
References......Page 341
Appendix 31.1 Recommendations for treatment of specific microorganisms.......Page 345
5: Late Cutaneous Events from Cancer Treatment......Page 349
Radiation-induced cutaneous neoplasms......Page 351
Association with chronic immunosuppression......Page 357
Cutaneous metastases......Page 358
Metastases from solid organ malignancies......Page 359
Metastases from hematologic malignancies......Page 362
Chronic radiation dermatitis......Page 363
Necrosis of soft tissue, cartilage, or bone......Page 365
Subdermal fibrosis......Page 366
Grading......Page 367
Scars......Page 368
References......Page 369
6: Dermatologic Practice in Oncology......Page 377
33: Management Algorithms for Dermatologic Adverse Events......Page 379
References......Page 393
Types of moisturizers......Page 396
Keratolytic therapy......Page 397
Sunscreens and sun blocks......Page 398
Picaridin......Page 399
Topical antibacterial therapy......Page 400
Topical antiviral therapy......Page 401
Topical therapy for cutaneous warts......Page 402
Amphotericin B......Page 403
Hydroxypyridones......Page 404
Systemic corticosteroids......Page 405
Topical antipruritic therapy......Page 406
Topical retinoids......Page 407
AEs......Page 408
References......Page 409
Local anesthetic and technique......Page 413
Wound dressings......Page 414
Shave biopsy......Page 415
Punch biopsy......Page 416
Incisional biopsy and excisional biopsy......Page 417
Nail plate avulsion and chemical cauterization......Page 418
Atypical mycobacterial and deep fungal culture......Page 419
References......Page 420
Treatment options......Page 422
Areola tattoos......Page 423
Sensitive skin from chemotherapy......Page 424
Treatment options......Page 425
References......Page 426
Index......Page 429