Epidermal growth factor inhibitors (EGFRI), the first targeted cancer therapy, are currently an essential treatment for many advance-stage epithelial cancers. These agents have the superior ability to target cancers cells and better safety profile compared to conventional chemotherapies. However, cutaneous adverse events are common due to the interference of epidermal growth factor receptor (EGFR) signaling in the skin. Cutaneous toxicities lead to poor compliance, drug cessation, and psychosocial discomfort. This paper summarizes the current knowledge concerning the presentation and management of skin toxicity from EGFRI. The common dermatologic adverse events are papulopustules and xerosis. Less common findings are paronychia, regulatory abnormalities of hair growth, maculopapular rash, mucositis, and postinflammatory hyperpigmentation. Radiation enhances EGFRI rash due to synergistic toxicity. There is a positive correlation between the occurrence and severity of cutaneous adverse effects and tumor response. To date, prophylactic systemic tetracycline and tetracycline class antibiotics have proven to be the most effective treatment regime.

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, severe adverse drug reaction. The aim of this study was to characterize the aetiology, clinical features, laboratory findings, and management of patients with DRESS, diagnosed from January 2005 to April 2010 in a tertiary centre in Thailand. Twenty-seven patients were included in the study with a mean age of 52 years. Phenytoin, allopurinol, and nevirapine were the most commonly implicated medications. Mean duration of drug administration before the onset of symptoms was 34 days. The latent period was longer for allopurinol (103 days) and shorter for nevirapine (10 days). Skin rash was seen in all patients, while fever and lymphadenopathy were found in 88.9% and 22.2%, respectively. Hepatic and haematological involvement were the two most common systemic complications, occurring in 96.3% and 85.2%, respectively. Most patients were treated with systemic corticosteroids, for a mean duration of 49 days. The mortality rate in this study was 3.7%. Early detection and discontinuation of the suspected drug are the key steps of management.

Background. Leprosy is a chronic infectious disease that presents with varying dermatological and neurological symptoms. The leprosy reactions occur over the chronic course of the disease and lead to extensive disability and morbidity. Objective. To analyze and identify the risk factors which contribute to leprosy reactions. Methods. In a retrospective study, we reviewed the medical records of leprosy patients registered at the leprosy clinic, Ramathibodi Hospital, Thailand, between March 1995 and April 2015. One hundred and eight patients were included; descriptive analysis was used for baseline characteristics and a binary logistic regression model was applied for identifying risk factors correlated with leprosy reactions. Results. Of the 108 cases analyzed, 51 were male and 57 were female. The mean age of presentation was 45 years. The borderline tuberculoid type was the most common clinical form. Leprosy reactions were documented in 61 cases (56.5%). The average time to reaction was 8.9 months. From multivariate analysis, risk factors for leprosy reactions were being female, positive bacillary index status, and MB treatment regimen. Conclusions. Leprosy reactions are common complications in leprosy patients. Being female, positive bacillary index status, and multibacillary treatment regimen are significantly associated with the reactions. Early detection in cases with risk factors followed by appropriate treatment could prevent the morbidity of leprosy patients.