Algorithm for dermocosmetic use in the management of cutaneous side‐effects associated with targeted therapy in oncology

Abstract

Currently, numerous patients who receive targeted chemotherapy for cancer suffer from disabling skin reactions due to cutaneous toxicity, which is a significant problem for an increasing number of patients and their treating physicians. In addition, using inappropriate personal hygiene products often worsens these otherwise manageable side-effects. Cosmetic products for personal hygiene and lesion camouflage are part of a patients’ well-being and an increasing number of physicians feel that they do not have adequate information to provide effective advice on concomitant cosmetic therapy. Although ample information is available in the literature on pharmaceutical treatment for cutaneous side-effects of chemotherapy, little is available for the concomitant use of dermatological skin-care products with medical treatments. The objective of this consensus study is to provide an algorithm for the appropriate use of dermatological cosmetics in the management of cutaneous toxicities associated with targeted chemotherapy such as epidermal growth factor receptor inhibitors and other monoclonal antibodies. These guidelines were developed by a French and German expert group of dermatologists and an oncologist for oncologists and primary care physicians who manage oncology patients. The information in this report is based on published data and the expert group’s opinion. Due to the current lack of clinical evidence, only a review of published recommendations including suggestions for concomitant cosmetic use was conducted.

Chemotherapy: oral side effects and dental interventions. A review of the literature

“…The chronic form is characterized by sensory paresthesias, dysesthesias, and ataxia of the extremities. Furthermore, endocrine disorders (hypothyroidism), [19] liver disease, and cutaneous disordersclosely related to targeted chemotherapy (rash, xerosis, paronychia) [20] have been related to chemotherapy.…”

Barrier protective use of skin care to prevent chemotherapy-induced cutaneous symptoms and to maintain quality of life in patients with breast cancer

“…However, the success of specific prophylactic strategies depends very much on the pathomechanism of individual reaction patterns, and these are not necessarily specific to substances or their combinations 16. Also, it is important to distinguish between toxic and nontoxic reactions.…”

Barrier protective use of skin care to prevent chemotherapy-induced cutaneous symptoms and to maintain quality of life in patients with breast cancer

“…[13][14][15] However, the success of specific prophylactic strategies depends very much on the pathomechanism of individual reaction patterns, and these are not necessarily specific to substances or their combinations. 16 Also, it is important to distinguish between toxic and nontoxic reactions. Unspecific cytotoxic effects on the epithelium or skin appendages caused by the cytostatics themselves or by their metabolites are the most common events and can be observed in up to 30% of all cancer patients, regardless of the type of the primary tumor, but dependent on the regimen and the combination of chemotherapy.…”

“…Here, the different pathomechanism of barrier dysfunction under therapy with cytostatics is ignored, and proactive use is propagated without scientific evidence. 16 The clinical use of a niacinamide-containing preparation implements the concept of using the well-known effects of the natural vitamin proactively to prevent clinically relevant chemotherapy-induced barrier dysfunction. [24][25][26][27][28] The advantages of niacinamide are its anti-inflammatory effects due to inhibition of proinflammatory factors, as well as its ability to increase the expression of serine palmitoyltransferase as the key enzyme for ceramide synthesis.…”

“…23 Up to now, only individual recommendations for supportive skin care, aiming at barrier substitution, can be found in literature. 16 These recommendations are based on concepts that have been established for chronic inflammatory skin diseases with endogenous barrier deficiency (eg, atopic dermatitis) and have been empirically applied to oncological situations. Here, the different pathomechanism of barrier dysfunction under therapy with cytostatics is ignored, and proactive use is propagated without scientific evidence.…”