Dermatologic diagnoses in oncology patients of color on anticancer therapy: Five-year retrospective review of outpatient dermatology consultations.

Abstract

12084 Background: Dermatologic toxicities from cancer treatments affecting patients from racial and ethnic minority backgrounds or skin of color (SOC) patients is an understudied area of research. These patients are also significantly underrepresented in therapeutic clinical trials, limiting complete understanding of toxicities associated with cancer therapies. Current treatment algorithms for dermatological adverse events (dAE) also do not take into account possible biologic differences in different skin types affecting toxicity presentation and treatment response. In this study we summarize the demographic, clinical, and treatment characteristics of oncology patients from racial and ethnic minority backgrounds who developed dermatologic adverse events related to cancer therapies. Methods: We performed a retrospective review of all SOC patients (Asian, Black, Hispanic) on active cancer therapy who received outpatient dermatology consultation at Memorial Sloan Kettering Cancer Center from January 1, 2014 to December 31, 2019. Electronic health record information for 2917 patients was obtained. A computational keyword-based text analysis of medical chart text, developed in consultation with a board-certified dermatologist, was performed to determine dermatologic diagnoses categories for each patient. All analyses were conducted using R statistical programming software, version 4.2.06. Results: There were 2917 outpatient dermatology consultations. Our population consisted of 1992 (68.29%) females and 925 (31.71%) males with a mean age of 53 (range 0-97). There were 35.55% Black, 41.28% Asian, 1.02% (30) Native American or Alaskan Native, 0.17% (5) Native Hawaiian or Other Pacific Islander. 729 were Hispanic ethnicity of which 641 were Caucasian. A total of 4,026 dermatologic diagnoses occurred in the study population. Bacterial infections were the most commonly observed, occurring in 15% of patients. Nail disorders were the second most common dAE, occurring in 14% of the study population, followed by eczema/eczematous reactions at 9%. In all racial groups, eczema/eczematous reactions, nail disorders, and dermatomyositis were in the top five most common observed dAEs. Asian patients made up the largest proportion of those who had morbilliform rash dAEs (55%) while Black patients made up the largest proportion of those with hyperpigmentation dAEs (54%) and vascular insufficiency dAEs (47%). Conclusions: The findings from our study indicate that pigmentary changes, bacterial infections, eczema/eczematous reactions, and nail disorders are the most common dAE types that occurred in our group of SOC patients. We hope to use this information to aid in the development of specific management strategies within the field of supportive oncodermatology to meet the needs of minority patient populations.