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

Abstract

PurposeChemotherapy with anthracyclines, taxanes, or alkylating agents often causes cutaneous side effects. Nonspecific inhibition of the proliferative activity of keratinocytes has antidifferentiation effects that lead to defects in the barrier function and, thus, to dry, itchy, and irritable skin. These cutaneous symptoms reduce the quality of life of the patients considerably. Conditioning with topical application of niacinamide uses the cytoprotective and barrier stabilizing effect of vitamin B3.Patients and methodsA multicenter randomized crossover study investigated the influence of the test preparation on the quality of life compared to standard care for 73 patients with breast cancer undergoing adjuvant or neoadjuvant cytostatic therapy. Primary target parameter was the Dermatology Life Quality Index with its respective subscales after 6 weeks of a twice-daily application of the respective preparations. Additionally, specific symptoms such as pruritus, dryness, and irritability have been assessed using visual analog scales.ResultsRegarding the total score of the Dermatology Life Quality Index, no relevant differences could be observed. However, the results for the “symptoms and feelings” subscale show a significant advantage in favor of the test preparation. Significant superiority of the test preparation could also be observed in the secondary target parameters, the visual analog scales (P<0.05).ConclusionThe results show for the first time a significant superiority of prophylactic application of niacinamide for maintaining quality of life while undergoing cytostatic treatment.

Effectiveness and Tolerability of Natural Herbal Formulations in the Prevention of Radiation-Induced Skin Toxicity in Patients Undergoing Radiotherapy

“…42 It has also been widely used in cancer patients, regardless of cancer type, cancer treatment, or protective skin care. 43,44 DLQI total score ranges from 0 to 30; lower scores indicate lower impairment of patient’s quality of life and higher scores indicate greater impairment. DLQI focuses mainly on physical limitations, which, in turn, implies that it is better at assessing the impact of severe (inflammatory) diseases than that of diseases with a relatively mild impact or with few physical symptoms but high psychological impact.…”

Management of skin adverse reactions in oncology

“…Xerosis can be treated with standard emollients containing niacinamide. 33 Ointments however should be avoided because they can occlude the fissures and cause a follicular rash. 24 Severely xerotic skin may be at risk for infections, with this risk being potentiated by itching and scratching.…”

Profile of Skin pH in Leukaemia’s Children with Chemotherapy Treatments at Haji Adam Malik General Hospital, Medan

“…This is in line with the study by Wohlrab et al which states that the nonspecific effects of chemotherapy drugs on skin epithelium and surrounding tissue can be observed in about 30% of cancer patients, regardless of the type of cancer. Factors that play a role in the emergence of such effects is regimens and combinations of chemotherapy used [ 12 ].…”