MANAGEMENT OF PAPULO-PUSTULAR RASH INDUCED BY
EPIDERMAL GROWTH FACTOR RECEPTOR INHIBITORS
CORNELIA NITIPIR1,2, MARIA ALEXANDRA BARBU2*, LILIANA GABRIELA POPA1,3, MARA MADALINA MIHAI1,3, IRINA RADU2, DANIEL MIREA4, CALIN GIURCANEANU1,3, RĂZVAN VALENTIN SCĂUNAȘU1,5
1“Carol Davila” University of Medicine and Pharmacy
2Elias University Emergency Hospital, Department of Oncology
3Elias University Emergency Hospital, Department of Dermatology
4Elias University Emergency Hospital, Department of Otolaryngology
5Colțea Universitary Hospital, Department of General Surgery
*corresponding author: m.barbu86@gmail.com
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Abstract:
Epidermal growth factor receptor inhibitors (EGFRI) are used for the treatment of advanced colorectal, head and neck,
pancreatic, and non-small cell lung cancers. Although EGFRI have a much better tolerability profile compared with
conventional cytotoxic drugs, they are associated with significant skin toxicity. The most frequent dermatologic side effect is
the papulo-pustular rash (PPR). It often leads to dose reductions or discontinuation of therapy. However, therapeutic response
and survival are directly proportional to PPR severity. Patients with severe PPR should not discontinue treatment as they are
expected to have the best clinical outcome. Therefore, prophylactic treatment or prompt intervention are essential for rash
management and maintenance of patient tolerance and compliance. Further studies are urgently needed in order to establish
evidence-based approach algorithms to the management of EGFRI induced skin toxicity and to optimize the benefits of this
antineoplastic therapy. Our aim is to discuss the clinical presentation, pathophysiology, and treatment options in EGFRIinduced
PPR.

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