RESUMO
The frequency of the use of drugs that act on the epidermal growth factor receptor (EGFR) is increasing, with the consequent onset of cutaneous toxicity, specifically acneiform eruption. The authors extensively review the topic, focusing on describing how these drugs can affect the skin and its appendages, that is, the pathophysiology that encompasses the cutaneous toxicity related to the use of EGFR inhibitors. In addition, it was possible to list the risk factors that may be associated with adverse effects of these drugs. Based on this recent knowledge, the authors expect to aid in the management of patients who are more vulnerable to toxicity, reduce morbidities, and improve the quality of life of patients undergoing treatment with EGFR inhibitors. Other issues related to the toxicity of EGFR inhibitors, such as the clinical aspects of the acneiform eruption grades, and other different types of cutaneous and mucosal reactions, are also included in the article.
Assuntos
Erupções Acneiformes , Antineoplásicos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Receptores ErbB , Humanos , Erupções Acneiformes/induzido quimicamente , Erupções Acneiformes/tratamento farmacológico , Antineoplásicos/efeitos adversos , Biomarcadores , Receptores ErbB/antagonistas & inibidores , Qualidade de Vida , Fatores de RiscoRESUMO
Abstract Bromoderma is a cutaneous eruption caused by the absorption of bromide. Clinical manifestations include acneiform and vegetative lesions. We report the case of an infant with bromoderma caused by the use of syrup for abdominal colic containing calcium bromide. The lesions regressed after discontinuation of the drug.
Assuntos
Humanos , Masculino , Lactente , Brometos/efeitos adversos , Toxidermias/etiologia , Toxidermias/patologia , Compostos de Cálcio/efeitos adversos , Pele/patologia , Cólica/tratamento farmacológico , Erupções Acneiformes/induzido quimicamente , Erupções Acneiformes/patologiaRESUMO
Bromoderma is a cutaneous eruption caused by the absorption of bromide. Clinical manifestations include acneiform and vegetative lesions. We report the case of an infant with bromoderma caused by the use of syrup for abdominal colic containing calcium bromide. The lesions regressed after discontinuation of the drug.
Assuntos
Brometos/efeitos adversos , Compostos de Cálcio/efeitos adversos , Toxidermias/etiologia , Toxidermias/patologia , Erupções Acneiformes/induzido quimicamente , Erupções Acneiformes/patologia , Cólica/tratamento farmacológico , Humanos , Lactente , Masculino , Pele/patologiaRESUMO
BACKGROUND: The first therapeutic choice for the treatment of cutaneous sporotrichosis is oral itraconazole; however, the increase in cases of zoonotic transmission outbreak necessitates a search for effective and safe treatment alternatives. OBJECTIVE: To evaluate a new potassium iodide (KI) posology as an alternative for the treatment of limited cutaneous forms of sporotrichosis. METHODS: One hundred and two patients with sporotrichosis diagnosed by isolation of Sporothrix sp. were included and were divided into 2 groups that received different doses of KI: group A received the conventional dose, and group B received the reduced dose. The cure criteria were based on clinical and serological data. RESULTS: Seventy-nine patients (77.4%) reached clinical cure: 70.6% and 84.3% of groups A and B respectively. Sixteen patients (15.6%) were lost during follow-up, and seven changed drug therapy: five in group A and two in group B. The incidence of adverse events was similar for both groups (64.7%): predominantly metallic taste (44%), followed by mild gastrointestinal intolerance and acneiform eruption (10.7% each). No serious adverse events occurred, and there were no recurrences. Analysis of the results showed no statistically significant difference between groups (P = 0.9255). The improvement in serologic titres was significant in both treatment groups. CONCLUSION: Through statistical analysis, the usual posology was not shown to be superior to the one proposed in this study. Serology for sporotrichosis may be used as a valuable tool in the clinical monitoring of these patients.
Assuntos
Antifúngicos/administração & dosagem , Iodeto de Potássio/administração & dosagem , Esporotricose/tratamento farmacológico , Erupções Acneiformes/induzido quimicamente , Adolescente , Adulto , Antifúngicos/efeitos adversos , Criança , Pré-Escolar , Toxidermias/etiologia , Feminino , Humanos , Masculino , Náusea/induzido quimicamente , Iodeto de Potássio/efeitos adversos , Testes Sorológicos , Sporothrix/imunologia , Distúrbios do Paladar/induzido quimicamente , Resultado do TratamentoRESUMO
BRAF inhibitors (BRAFi) and MEK inhibitors (MEKi) increase survival in BRAF mutant metastatic melanoma patients; however, they induce a well-known spectrum of cutaneous side effects during treatment. Whereas the BRAFi dabrafenib induces cutaneous squamous cell carcinomas and verrucal keratosis, the MEKi trametinib frequently induces acneiform eruptions that are reversible after drug discontinuation. Furthermore, when dabrafenib and trametinib are used in combination, there are fewer cutaneous toxicities. We report a patient with BRAF mutant metastatic melanoma treated with the BRAFi/MEKi combination therapy who developed an acneiform eruption after treatment discontinuation rather than during active therapy. Moreover, the eruption resolved when the combination treatment was reintroduced and recurred after increasing the dose of trametinib. The eruption may be explained by the longer half-life of trametinib (4.5 days) compared with dabrafenib (5.2 h). This is the first case reported with this particular side effect induced after stopping the treatment and could become more frequent as the BRAFi/MEKi combination of drugs is more frequently prescribed.
Assuntos
Erupções Acneiformes/complicações , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Imidazóis/administração & dosagem , Melanoma/complicações , Oximas/administração & dosagem , Piridonas/administração & dosagem , Pirimidinonas/administração & dosagem , Neoplasias Cutâneas/complicações , Erupções Acneiformes/induzido quimicamente , Corticosteroides/efeitos adversos , Adulto , Progressão da Doença , Esquema de Medicação , Evolução Fatal , Feminino , Febre/induzido quimicamente , Humanos , Melanoma/tratamento farmacológico , Mutação , Metástase Neoplásica , Proteínas Proto-Oncogênicas B-raf/genética , Neoplasias Cutâneas/tratamento farmacológico , Fatores de Tempo , Resultado do TratamentoRESUMO
Multiple sclerosis is an inflammatory demyelinating disease of presumed autoimmune origin that affects the central nervous system. The main form of therapy is based on the use of immunomodulators such as interferon beta, which are usually well tolerated. Skin manifestations resulting from treatment with interferon beta-1b consist principally of reactions at the site of subcutaneous application of the drug. The present case report describes a female patient who developed an acneiform eruption resulting from treatment with interferon beta-1b.
Assuntos
Erupções Acneiformes/induzido quimicamente , Adjuvantes Imunológicos/efeitos adversos , Toxidermias , Interferon beta/efeitos adversos , Erupções Acneiformes/diagnóstico , Doença Aguda , Adjuvantes Imunológicos/uso terapêutico , Adulto , Toxidermias/diagnóstico , Feminino , Humanos , Interferon beta-1b , Interferon beta/uso terapêutico , Masculino , Esclerose Múltipla/tratamento farmacológicoRESUMO
Esclerose múltipla é uma doença inflamatória desmielinizante, com presumida origem autoimune, que afeta o sistema nervoso central. A principal modalidade terapêutica é baseada no uso de imunomoduladores, como o interferon beta, que são geralmente bem tolerados. As manifestações cutâneas secundárias ao interferon beta-1b são representadas, na maioria das vezes, por reações no local de sua aplicação subcutânea. Descrevemos o caso de uma paciente do sexo feminino que desenvolveu um quadro de erupção acneiforme pelo interferon beta-1b.
Multiple sclerosis is an inflammatory demyelinating disease of presumed autoimmune origin that affects the central nervous system. The main form of therapy is based on the use of immunomodulators such as interferon beta, which are usually well tolerated. Skin manifestations resulting from treatment with interferon beta-1b consist principally of reactions at the site of subcutaneous application of the drug. The present case report describes a female patient who developed an acneiform eruption resulting from treatment with interferon beta-1b.