Acneiform rash — skin toxic reaction to the use of EGFR inhibitors

Abstract

Introduction.Inhibitors of the epidermal growth factor receptor cause the heavy dermatological adverse events, which can be the cause of change of the scheme of treatment. Acneiform rash is connected with specific inflammation of hair follicles, its weight depends on a dose of medicine and correlates with the best response to therapy at various options of tumors, in this regard effective correction of this side effect is of particular importance.Materials and methods. There were 32 patients with acneiform rash for observation; they have been divided into 3 groups. All patients received system antibacterial therapy: doxycycline 100 mg 2 times a day 10 days and topical medicines for external therapy, various on the action mechanism (tacrolimus, metronidazole, betamethasone valerate in a combination with fusidic acid). Acne Dermatology Index and Dermatology Life Quality Index were used for assessment. The received results were assesed on each visit of the patient, the final point of observations was in 3 months.Results.The significant regression of rash in all groups was in the 1st week when patients accepted doxycycline per os. Further the weakest response to therapy has shown cream with tacrolimus, the patients using gel with metronidazole has shown bigger effect, the fastest regress of Acne Dermatology Index and Dermatology Life Quality Index was observed in the patients used the combined cream with betamethasone and fusidic acid.Conclusions.The antibacterial therapy by doxycycline 100 mg 2 times a day per os at early stages of development of acneiform rash at the I—II severity gives the expressed effect and prevents deterioration of the .skin process. The combined therapy of acneiform rash of the I—II degree including doxycycline with topical cream containing a betamethasone valerate 0.1 % and fusidic acid 20 % renders the fastest and expressed effect in comparison with other combinations: the doxycycline and cream containing tacrolimus; the doxycycline and gel containing metronidazole.