Neželeni učinki zdravil za sistemsko zdravljenje raka na koži
Cytostatic and targeted drug-induced skin toxicities

  • Janja Ocvirk Onkološki inštitut, Ljubljana
Keywords: cytostatic drugs, skin toxicities, skin, side-effects

Abstract

Zdravljenje s citostatiki povzroča številne neželene učinke, med katerimi jih kar nekaj prizadene tudi kožo in sluznice, saj so v njih celice, ki se hitro delijo in prav na te celice citostatiki najmočneje vplivajo. Kožna toksičnost se ob zdravljenju s citostatiki lahko izraža kot sindrom roka – noga, dermatitis, eksantem, eritroderma, hiperpigmentacija. Paleta neželenih učinkov na kožo pri uporabi tarčnih zdravil pa je razen sindroma roka – noga ob multitarčnih zdravilih nekoliko drugačna. Pri uporabi zaviralcev EGFR je pogosto izražena kožna toksičnost, najpogosteje akniformni izpuščaj. Kseroze, ekceme, poke kože, teleangiektazije, spremembe nohtov in paronihijo opažamo pri nekaterih bolnikih, hiperpigmentacije kože pa so redkejše. Obvladovanje kožnih sprememb pomaga bolnikom prebroditi neželene učinke, pri čemer je izredno pomembno sodelovanje bolnikov. Kožna toksičnost je navadno obvladljiva s topično ali sistemsko uporabo zdravil, včasih pa je treba zmanjšati odmerek citostatika ali tarčnega zdravila oz. prilagoditi shemo zdravljenja. Poduk bolnikov pred zdravljenjem in hitro ukrepanje ob prvih znakih kožne toksičnosti sta ključna za uspeh.

Abstract (Eng)

The patients treated with cytostatic drugs may experience many side-effects, among them also skin and mucosal side-effects because skin and mucosal cells rapidly divide and are therefore most sensitive to cytostatics. The most common skin side-effects are hand-foot syndrome, eczema, erythroderma, hyperpigmentation. Skin toxicity of targeted drugs is different with the exception of hand-foot syndrome. EGFR-inhibitors often cause skin toxicity, most frequently acneiform eruption. Xerosis, eczema, fissures, teleangiectasias, nail changes and paronychia can be seen in some cases, rarely hyperpigmentation. Management of the skin toxicity helps patients to overcome cytostatics- and EGFR- inhibitors associated skin toxicity and is of great importance for patients’ compliance. It is generally manageable with standard topical or systemic antibiotics and anti-inflammatory agents; In some cases, it is nevertheless necessary to reduce doses of the drugs. Education of patients prior to beginning the therapy and proactive intervention at the first signs of skin toxicity are keys to successful management.
Published
2009-06-15
How to Cite
Ocvirk, J. (2009). Cytostatic and targeted drug-induced skin toxicities. Onkologija : A Medical-Scientific Journal, 13(1), 37-40. Retrieved from https://revijaonkologija.si/Onkologija/article/view/345
Section
Review Article
Page
37-40