Managing Dermatologic Complications in Oncology

Patients with cancer frequently experience a wide spectrum of dermatologic, hair, and nail changes, along with mucosal surface issues, as a direct consequence of their treatments. These adverse effects (AEs) observed are dependent upon the treatment administered and require qualified clinicians to understand and determine specific treatment options.

Jonathan Leventhal, MD, director of the residency program, director of the Onco-Dermatology Clinic, and associate professor term at Yale School of Medicine, spoke with CancerNetwork® about observed AEs and how he and his team go about diagnosing and treating them. Some observed effects include those on the hair, nails, and skin and can occur from received treatment such as targeted therapies or immunotherapies.

The advent of targeted therapies has introduced a new profile of dermatologic toxicities, including acneiform and hand-foot skin reaction. Furthermore, these agents can contribute to a predisposition for nail infections, a common and often painful complication. With the increasing use of immune checkpoint inhibitors, clinicians are encountering a unique set of dermatologic AEs. Additionally, radiation therapy, a cornerstone of cancer treatment, is well-known for inducing localized skin reactions such as radiation dermatitis.

Transcript:

Patients who are undergoing cancer treatment frequently have many issues that impact their skin, hair, nails, and mucosal surfaces. A lot depends on the type of treatment that they’re on. For instance, chemotherapy often results in hair loss; nail changes; multiple types of skin rashes, such as toxic erythema of chemotherapy; and mucositis. Patients who are on targeted therapies often have acne-type rashes or a hand-foot skin reaction and other issues that can impact their hair and nails. We see [many] nail infections. Patients on immune checkpoint inhibitor therapy can have a variety of rashes. These are often autoimmune in nature. They [experience] a lot of itching as well. Radiation can cause a lot of skin reactions, such as radiation dermatitis, among others. All types of cancer therapy can result in dermatologic complications.