Diagnostic accuracy of general dermatologists and supportive oncodermatologists for biopsied cutaneous immune-related adverse events

Thompson, Leah L.; Said, Jordan T.; Li, Edward B.; Yoon, Jaewon; Krasnow, Nira A.; Molina, Gabriel E.; Polyakov, Nicole J.; Foreman, Ruth K.; LeBoeuf, Nicole R.; Chen, Steven T

doi:10.1007/s00520-022-07233-w

Cited by 3 publications

(2 citation statements)

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“…Evaluation by a dermatologist was associated with better outcomes, and ICI retrial is a likely important contributing factor, returning to the connection between ciRAEs and survival highlighted above. Additional work has highlighted that even greater training and experience can improve specificity, where supportive oncodermatologists, in particular, have increased diagnostic accuracy compared to general dermatologists in the evaluation of biopsied cirAEs 53 . The study led by Thompson et al used billing and pathology requisition codes to retrospectively identify patients at Mass General Brigham/Dana‐Farber Cancer Institute who received anti‐PD‐1/PD‐L1 therapy between 2010 and 2019 and subsequently developed a cirAE that was biopsied by any dermatologist.…”

Section: Importance Of Dermatologic Evaluation In Patient Outcomesmentioning

confidence: 99%

Cutaneous immune‐related adverse events from immune checkpoint inhibitor therapy: Moving beyond “maculopapular rash”

Allais

Fay

Semenov

et al. 2023

Immunological Reviews

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SummaryUncoupling toxicity from therapeutic effect lies at the foundation of the current state of the field of cutaneous immune‐related adverse events to immune checkpoint inhibitor therapy. This will be achieved through understanding the drivers of toxicity, tumor response, and resistance via large, well‐powered population‐level studies, institutional cohort data, and cellular‐level data. Increasing diagnostic specificity through the application of consensus disease definitions has the power to improve clinical care and each approach to research. Cutaneous immune‐related adverse events are associated with increased survival, and their treatment must invoke the maintenance of a delicate balance between immunosuppression, anti‐tumor effect of immune checkpoint inhibitor therapy, and quality of life. The multidisciplinary care of cancer patients with adverse events is critical to optimizing clinical and translational research outcomes and, as such, dermatologists are vital to moving the study of cutaneous adverse events forward.

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Section: Importance Of Dermatologic Evaluation In Patient Outcomesmentioning

confidence: 99%

Cutaneous immune‐related adverse events from immune checkpoint inhibitor therapy: Moving beyond “maculopapular rash”

Allais

Fay

Semenov

et al. 2023

Immunological Reviews

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“…1,2 La incidencia mundial de cáncer en la población pediátrica se reporta en 18.7/100,000 niños; 3 siendo las manifestaciones dermatológicas frecuentes y asociadas específicamente a los diferentes tipos de terapias utilizadas en el tratamiento; las cuales se manifiestan como reacciones que involucran piel y faneras. 4,5 Entre los principales eventos dermatológicos adversos descritos en el paciente pediátrico con diagnóstico oncológico ya sea secundario a terapia dirigida o quimioterapia citotóxica, se incluyen pero no se limitan a erupciones cutáneas, xerosis, urticaria, prurito, mucositis, alopecia, lesiones proliferativas de la piel, despigmentación de la piel y el cabello, síndrome de eritrodisestesia palmoplantar mano-pie, y reacción mano-piepiel, entre otras; [6][7][8] Estos eventos en la mayoría de los casos no representan riesgo de muerte para el paciente, no obstante, tienen el potencial de implicar graves deficiencias en la calidad de vida y las modificaciones de las dosis o interrupción de la terapia contra el cáncer que además puede afectar el resultado clínico; 6 por lo que el apoyo a través de la oncodermatología es de importancia, esta especialidad es un campo en crecimiento que brinda tratamiento y atención preventiva a estos pacientes; 9 con el propósito de prevenir manifestaciones graves que podrían RESUMEN. Antecedentes: Los pacientes oncológicos pediátricos pueden desarrollar lesiones dermatológicas secundario a terapia antineoplásica, afectando piel, cabello y uñas.…”

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Manifestaciones dermatológicas en pacientes oncológicos pediátricos en un hospital de tercer nivel de Honduras

Williams

Montiel²,

Varela³

2023

Rev Méd Hondur

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Antecedentes: Los pacientes oncológicos pediátricos pueden desarrollar lesiones dermatológicas secundario a terapia antineoplásica, afectando piel, cabello y uñas. Objetivo: Describir las manifestaciones dermatológicas en los pacientes oncológicos pediátricos hospitalizados. Métodos: Estudio descriptivo transversal llevado a cabo en sala de Hemato-Oncología Pediátrica, Hospital Escuela, período enero-junio 2022. Fueron incluidos 86 pacientes que presentaron manifestaciones dermatológicas durante el período del estudio. Para el análisis se generaron resultados como frecuencias, porcentajes y estadística descriptiva. La proporción de pacientes con manifestaciones dermatológicas se determinó como número total de pacientes con diagnósticos dermatológicos en el período del estudio/número total de pacientes hospitalizados en la sala de Hemato-Oncología Pediátrica multiplicado por 100. Resultados: La edad media fue 9.4 años (DS +/-5.0; rango: 5 meses-18 años). Predominó sexo masculino 62.8% (54/86), procedencia de Francisco Morazán 41.9% (36/86) y ambiente rural 53.5% (46/86). El diagnóstico oncológico fue leucemia linfoblástica aguda 60.5% (52/86), la clasificación fue malignidades hematológicas 67.4% (58/86). El principal fármaco oncológico administrado fue Vincristina 76.7% (76/86). El principal agente antineoplásico administrado fue alcaloides vegetales 75.6% (65/86). El tipo de lesión eritema 38.5% (34/86); la localización de la lesión fue en piel 47.6% (41/86). El diagnóstico dermatológico fue alopecia y mucositis 36.0% (31/86) respectivamente. La proporción de lesiones dermatológicas fue de 65.1% (86/132) y fueron clasificadas como secundarias al tratamiento oncológico 82.6% (71/86). Discusión: La proporción de lesiones dermatológicas fue 65%, siendo las principales manifestaciones alopecia y mucositis, posiblemente secundario a la administración de terapia antineoplásica específicamente alcaloides vegetales, similar a lo reportado en la literatura.

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International Survey on Training of Residents in Dermatology in Supportive Oncodermatology: The Rescue Study

Ortiz-Brugués,

Fattore,

Boileau

et al. 2024

Preprint

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Purpose Dermatologic management of cancer patients with cutaneous adverse events, acquired during and after oncologic treatments, is known as supportive oncodermatology. This subspecialty within dermatology includes the prevention, early identification, and mitigation of dermatologic toxicities affecting the skin, hair, nails, and mucous membranes resulting from chemotherapy, targeted therapies, immunotherapy, endocrine therapies and radiation therapy. Methods The European Academy of Dermatology and Venereology (EADV) Task Force “Dermatology for Cancer Patients,” in partnership with the US Oncodermatology Society conducted this international questionnaire-based study RESCUE (RESIDENTS SURVEY ON TRAINING OF DERMATOLOGY RESIDENTS IN SUPPORTIVE ONCODERMATOLOGY), aiming to evaluate the current state of knowledge and training in supportive oncodermatology. Results 442 dermatology residents from 20 countries participated in the RESCUE study. Main results showed that dermatology residents declared to be less trained in supportive oncodermatology (only 41% received complete training) compared to immunodermatology (75%), cutaneous oncology (75%), dermoscopy (64%) and dermatologic surgery (50%). Only 17% of residents affirmed feeling comfortable dealing with dermatological toxicities of anticancer treatments. Residents stated being less educated in the management of dermatological toxicities of endocrine therapies (28%). They felt less qualified in nail, hair and oral toxicities. 98% of residents considered that improving training on dermatological toxicities of anticancer therapies is important during residency. Conclusion A specific dedicated residency program including a more practical approach, together with an extended training in endocrine therapies, as well as hair, nail and oral toxicities, would improve the skills of dermatology residents in the management of cutaneous adverse events of anticancer therapies.

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Diagnostic accuracy of general dermatologists and supportive oncodermatologists for biopsied cutaneous immune-related adverse events

Cited by 3 publications

References 20 publications

Cutaneous immune‐related adverse events from immune checkpoint inhibitor therapy: Moving beyond “maculopapular rash”

Cutaneous immune‐related adverse events from immune checkpoint inhibitor therapy: Moving beyond “maculopapular rash”

Manifestaciones dermatológicas en pacientes oncológicos pediátricos en un hospital de tercer nivel de Honduras

International Survey on Training of Residents in Dermatology in Supportive Oncodermatology: The Rescue Study

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