Head-neck Malignancies Research Articles

Effects of Radiation on Olfactory Function in Head and Neck Malignancy.

Olfactory dysfunction is an overlooked adverse effect of radiation therapy. This study is designed to find the effect of radiation therapy on olfactory function in head and neck malignancy excluding tumors of nose and nasopharynx and correlate the olfactory changes with the radiotherapy dose. This prospective observational study was done over a 2-year period in 34 participants with head and neck malignancies who underwent radiation therapy (RT). The participants olfaction was evaluated subjectively with Italian Nose Obstruction Symptom Evaluation (I-NOSE) scale and objectively by a modified I-Smell test which included an olfactory identification score and an olfactory threshold score at 5 time points. The beginning of RT (T0), at 2 weeks of RT(T1), end of RT (T2), 1 month follow-up (T3), and 3-month follow-up (T4). The near maximum dose to the nasal cavity (D2%) and mean dose to the nasal cavity (Dmean) were calculated for all participants and correlated with olfactory function. A total of 34 patients with head neck malignancy were recruited. The median I-NOSE score reached maximum at the end of radiation and decreased to baseline at 3 months follow-up (P < .001). The olfactory identification score, olfactory threshold score, and median combined olfactory score showed a significant decrease at the end of radiation therapy compared to Pre-radiation therapy values. There was a significant but incomplete recovery in the 3-month follow-up period (P < .001). There was a significant deterioration in quality of life for olfaction, olfactory identification, and olfactory threshold at the completion of radiotherapy. At 3 months follow-up, though there was no complete recovery of olfaction, it did not have an adverse effect on the quality of life.

Parathyroid carcinoma: lessons from a rare malignancy of head and neck-a case series.

Parathyroid carcinoma (PC) is a very rare head-neck malignancy. Because the symptoms of parathyroid carcinoma are similar to those of benign causes of hyperparathyroidism, it may be not easy to detect it before surgery. The management of PC after initial surgery will be perplexing because of the adequacy of surgery. We wish to describe the difficulties encountered throughout treatment using a literature review. We conducted a retrospective analysis of individuals with parathyroid carcinoma who had treatment at our department between 2017 and 2022. We gathered data on the clinical profile, investigations, management of hypercalcemia, surgical techniques, histopathological features, adjuvant therapy, and outcomes. We treated three patients with parathyroid carcinoma: Two patients with inferior parathyroid carcinoma and one with superior parathyroid carcinoma. Generalized weakness and bony pain are the predominant symptoms. In all cases, the tumor was located using 99Tc MIBI / SPECT scintigraphy and Ultrasonography. Hemithyroidectomy and tumor excision were done as the surgery of choice. All are disease-free at the 12th-month follow-up. We suggested that parathyroid hormone testing be performed in all bony fibrous lesions to rule out hyperparathyroidism. PC is a likely diagnosis when there is noticeable throat swelling, elevated PTH levels greater than 400IU/L, and serum calcium levels greater than 15mg/dL.

Role of Fine Needle Aspiration Cytology (FNAC) in Preoperative Diagnosis of Parotid and Submandibular Gland Neoplasm

Background: The overall incidence of salivary gland neoplasm is 2.5-3.0 per 100000 per year. Salivary gland malignancies account for about 5% of head-neck malignancies. Though, it is uncommon but not rare in our country. Fine Needle Aspiration Cytology (FNAC) has been widely used for many years as a method for assessing salivary gland lesion preoperatively. It is a simple, quick, inexpensive and minimally invasive technique used to diagnose different types of salivary gland neoplasm. Objectives: To see the frequency of malignancy in parotid and submandibular salivary gland neoplasm and also to find out the role of FNAC in their preoperative diagnosis. Histopathological examination of the resected parotid and submandibular gland neoplasm was considered as gold standard to compare FNAC report of this study. Methods: This was a cross – sectional study which was conducted in the Department of Otolaryngology – Head &amp; Neck Surgery, Dhaka Medical College Hospital, Dhaka from January 2017 to June 2018. Purposive sampling method was used to collect data. Pre-tested structured data sheet was used to record information. After collection, data were edited by meticulous checking and re-checking. Data were analyzed using SPSS for windows version 22. Results: After histopathological confirmation of the resected specimen, most common benign parotid tumour was pleomorphic adenoma 76.7% followed by warthin’s tumour 16.7%. In benign submandibular gland neoplasm, pleomorphic adenoma was the commones 87.5% followed by haemangioma 12.5%. Commonest malignant tumour of submandibular gland was adenoid cystic carcinoma 50.0%. In our study sensitivity of FNAC was 75.0%, specificity 94.74% and overall accuracy was 90%. Positive predictive value and negative value were 81.82% and 92.31% respectively. Conclusion: It can be concluded that fine needle aspiration cytology is a safe, cheap and useful preoperative diagnostic tool in the diagnosis of malignancy in parotid and submandibular gland, but as fine needle aspiration cytology partly depends on operator skill, it may give false negative and false positive result. Bangladesh J Otorhinolaryngol 2021; 27(2): 124-129

Analysis of Race and Gender Disparities in Mortality Trends from Patients Diagnosed with Nasopharyngeal, Oropharyngeal and Hypopharyngeal Cancer from 2000 to 2017.

BackgroundSquamous cell carcinoma of the nasopharynx, oropharynx and hypopharynx constitutes a majority of head neck malignancies. The incidence-based mortality across different races has been noted to be divergent. This study analyzes the trend in incidence-based mortality from the years 2000 to 2017 amongst both the genders in Caucasian/White and African American/Black patients.MethodsThe Surveillance, Epidemiology, and End Results (SEER) Database was queried to conduct a nation-wide analysis for the years 2000 to 2017. Incidence-based mortality for all stages of nasopharyngeal, oropharyngeal and hypopharyngeal cancer was queried and the results were grouped by race (Caucasian/White, African American/Black, American Indian/Alaskan native and Asian/Pacific Islander) and gender. All stages and ages were included in the analysis. t-test was used to determine statistically significant differences between various subgroups. Linearized trend lines were used to visualize the mortality trends of all sub groups.ResultsAcross all races, the male to female gender disparity in mortality was ~1:3 in patients with nasopharynx and became worse to ~1:4 and ~1:5 for patients with oropharyngeal and hypopharyngeal cancers, respectively. Notably, the highest incidence-based mortality for nasopharyngeal cancers is seen in Asian/pacific Islander males and a similar peak is noted for hypopharyngeal cancers in African American/Black males. Incidence-based mortality rates (per 1000) for nasopharyngeal, oropharyngeal and hypopharyngeal cancer of all races and both the genders was noted to be divergent.ConclusionA significant gender disparity exists in all three pharyngeal cancers across all races. It is unclear if female gender is protective but further study is warranted in a stage-specific and age-specific manner to better understand this disparity.

Is Cochlear Implantation Effective for Auditory Rehabilitation Following Vestibular Schwannoma Treatment?

Is Cochlear Implantation Effective for Auditory Rehabilitation Following Vestibular Schwannoma Treatment?

Current immuno-oncology in head and neck cancer

For many years surgery, radiotherapy and chemotherapy dominated the treatment in head and neck malignancies. Refinements of the particular techniques, either in surgery or in radiooncology, brought some progress. However, clinical outcome data are still not satisfying and side effects and long term toxicities are significant. Apart of the improvement of overall results, the reduction of side effects stays amain goal in this field. Targeted therapies as well as immune modulating therapies represent anew generation in the treatment of cancer. The development of new and highly effective substances makes rapid progress and immunotherapy has become astandard in the treatment of recurrent head and neck cancer. The following chapter will give you an actual review about the status quo of immunotherapy in head neck malignancies.

Impact of COVID-19 on Cancer Care: One Year Retrospective Study of Cancer Patients Affected With COVID-19 at a Tertiary Cancer Care Hospital in Eastern India

Aims and Objectives: The information regarding the nature of the novel corona virus, its spread, implications and treatment were controversial from the very beginning. Whether Cancer patients would do worse was not known to us, although the common belief was that they were high risk group considering the low immunity. To know these we have looked into our data over last one year. Materials and Methods: After Ethical committee permission we have done a retrospective analysis of our data from April, 2020 to March, 2021. The following were looked into- the footfall of new and follow up cases and compared them with the number of the preceding year.We also looked into the age, sex, type of cancer, stages at presentation, symptomatology, time to recovery, complications, delay in treatment and outcome. Results: There was 50% reduction in the number of new and follow up cases combined compared to the previous year. Majority of the 420 cancer patients who were infected were in the fifth decade, the commonest site being Head neck & haematological malignancies. Most of the cancer patients were asymptomatic. There was an average delay in treatment of 5 to 6 weeks. Only 1.67% succumbed to Covid before being referred outside, most of whom had haematological malignancies with multiple comorbidities. Conclusions: The pandemic has significantly affected the care of Cancer patients with less footfall, late presentation, delayed treatment with potentially worse outcome. Interestingly, although they have decreased immunity, majority were asymptomatic. Most of the fatalities were in the haemato-oncological malignancies with multiple co-morbidities. Funding Information: None. Declaration of Interests: None. Ethics Approval Statement: Clearance received from the Institute Ethics committee.

A COMPARATIVE STUDY ON COMPLICATIONS OF EMERGENCY AND ELECTIVE TRACHEOSTOMY IN ENT DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

Background: Both elective and emergency tracheostomy as life saving procedure is frequently performed. Tracheostomy can be associated with numerous (intraoperative and postoperative) complications. Methods: In this study 120 patients were studied age ranged from 9 years to 79 years in the Department of ENT, Darbhanga Medical College &amp; Hospital, Laheriasarai, Bihar from January 2020 to December 2020. Results: Among 120 tracheostomized patients, 75 (62.5%) were patients of emergency tracheostomy group and 45 (37.5%) were patients of elective tracheostomy group. Laryngeal carcinoma and other head-neck malignancy were the common (67.34%) indications for emergency tracheostomy. Maxillofacial and laryngeal surgery (50.1%) was the common indications for elective tracheostomy. Haemmorage was the most common complication. The second most common complication were subcutaneous surgical emphysema and wound infection. Then the tube displacement, perichondritis and stomal stenosis/ granulation tissue formation were the complications. In all stages (intraoperative, immediate postoperative, early postoperative and late postoperative), the frequency of complications was more in emergency tracheostomy and it was statistically signicant (p&lt;0.05). Conclusion: Complications are more in emergency than elective tracheostomy. Reduction of complications should be aim of all types of tracheostomy.

When is a surgical multidisciplinary approach required in the management of head and neck non-melanoma skin cancer and in advanced head and neck pathologies involving skin?

SUMMARYNon-melanoma Skin cancer, including cutaneous squamous cell carcinoma and basal cell carcinoma, is the most common form of malignancy in the Caucasian population, and the skin of the head and neck is the site most involved. They should not be underestimated; in particular, high-risk lesions and advanced skin cancers require accurate diagnostic work up, aggressive surgical treatment and should be managed by the head and neck surgeon, the dermatologist and the plastic surgeon. Cutaneous head-neck malignancies are often overlooked or not routinely treated with a multidisciplinary surgical approach. Similarly, for primary head and neck cancers with involvement of surrounding skin, the involvement of the dermatologist and the plastic surgeon could better define an adequate diagnosis and treatment planning. The management of these patients presents both therapeutic and ethical problems, because the poor prognosis is burdened by facial disfigurement, open malodorous wounds and intractable pain. Therefore, in patients with advanced disease that is not candidate to radical surgery, palliative surgery with flap reconstruction could take place and could be proposed to improve quality of life.

Prognostic Nutrition Index and Its Significance in Advanced Ovarian Cancer

The prognostic nutrition index (PNI) had been shown to be prognostic in various gastrointestinal and head neck malignancies. The aim of this study was to investigate the significance of PNI in advanced ovarian cancer with respect to clinical characteristics, treatment-related morbidity and response to platin-based chemotherapy. We prospectively investigated 286 patients who underwent primary or interval debulking surgery for advanced epithelial ovarian cancer between August 2017 and September 2019. All patients received 6 cycles adjuvant or neoadjuvant chemotherapy with carboplatin and paclitaxel. Pretreatment PNI was calculated as serum albumin (g/L) + 0.005 × lymphocyte count (per mm3). Optimal PNI cutoff value for disease-free survival (DFS) was identified using ROC curves. Comparisons between categorical variables were performed using Chi-square or Fisher’s exact tests, Cox regression analysis used for multivariate analyses and impact of PNI on DFS analyzed by Kaplan–Meier method and Cox proportional hazards model. The 47.85 cutoff value divided patients into high PNI and low PNI groups. No significant correlation was found between pretreatment PNI and age of patient, FIGO stage, residual disease after surgery, chemotoxicity or platinum resistance. However, low PNI was associated with high CA-125 levels (p < 0.001) and increased rate of postoperative complications (p = 0.036). In univariate analysis, PNI was not found to be associated with DFS (p = 0.103) but in multivariate analysis, PNI was independently associated with DFS (HR = 0.960, p = 0.013). Low PNI was significantly associated with increased CA-125 levels, increased rate of postoperative complications and low DFS.

Comparative Study of Serum Lipid Profile in Tobacco Addicts, Tobacco Non-addicts and Head-Neck Malignancy.

The present study was undertaken to evaluate lipid profile in tobacco consumers with and without head and neck malignancy and to see whether tobacco consumption causes same degree of alteration in lipid profile. Prospective study of serum lipid profile in 90 patients was done at Govt. Medical College Hospital. Various details of all participants such as age and sex of patients, detailed history of tobacco consumption were taken. Patients were divided into group I, II and III. Serum lipid profile was studied in 30 patients with tobacco addicts for more than 5years in the form of tobacco chewing and smoking without head-neck malignancy (Group I), 30 patients with tobacco addicts for more than 5 yrs in the form of tobacco chewing and smoking with head-neck malignancy (Group II) and 30 controls i.e., non-smokers and non-tobacco chewers (Group III). Statisticalanalysis was done to compare the serum lipid profile (Total Cholesterol, HDL, Ratio, Sr. triglyceride, VLDL, LDL) among the tobacco chewers with head and neck malignancy, non-tobacco consumers and tobacco consumers without malignancy and controls i.e., non-smokers and non-tobacco chewers. There was no significant change in total cholesterol, LDL, VLDL, HDL in patients with tobacco addicts and tobacco non-addicts. Serum triglycerides are significantly decreased in tobacco addicts and in malignancy. Total cholesterol, HDL, and LDL are significantly increased in malignancy as compared to tobacco addicts and tobacco non-addicts. There was no significant change in total cholesterol, LDL, VLDL, HDL in patients with tobacco addicts and tobacco non-addicts. Serum triglycerides are significantly decreased in tobacco addicts and in malignancy.

A clinical study of 150 cases of head neck cancer patients to identified the incidence of different site of head neck malignancy

A clinical study of 150 cases of head neck cancer patients to identified the incidence of different site of head neck malignancy

Analysis of race and gender disparities in mortality trends from patients diagnosed with nasopharyngeal, oropharyngeal and hypopharyngeal cancer from 2000 to 2014.

e17533 Background: Squamous cell carcinoma of the nasopharynx, oropharynx and hypopharynx constitutes a majority of head neck malignancies. The incidence-based mortality across different races has been noted to be divergent. This study analyzes the trend in incidence-based mortality from the years 2000 to 2014 amongst both the genders in Caucasian/White and African American/Black patients. Methods: The Surveillance, Epidemiology, and End Results (SEER) Database was queried to conduct a nation-wide analysis for the years 2000 to 2014. Incidence-based mortality for all stages of nasopharyngeal, oropharyngeal and hypopharyngeal cancer was queried and the results were grouped by race (Caucasian/White, African American/Black, American Indian/Alaskan native and Asian/Pacific Islander) and gender. All stages and ages were included in the analysis. T-test was used to determine statistically significance difference between various subgroups. Linearized trend lines were used to visualize the mortality trends of all sub groups. Results: Incidence-based mortality rates (per 1000) for nasopharyngeal, oropharyngeal and hypopharyngeal cancer all races and both the genders is shown in the table below. The male to female gender disparity in mortality is~ 1:3 in patients with nasopharynx across all races and becomes worse to ~1:4 and ~1:5 for patients with oropharyngeal and hypopharyngeal cancers respectively. Notably the highest incidence based mortality for nasopharyngeal cancers is seen in Asian/pacific Islander males and a similar peak is noted for hypopharyngeal cancers in African American/Black males. Conclusions: A significant gender disparity exists in all there pharyngeal cancers across all races. It is unclear if female gender is protective but further study is warranted in a stage- specific and age-specific manner to better understand this disparity.[Table: see text]

The oral pericommissural region: a distinct subsite—clinical features, histopathology, and treatment outcomes in 25 cases of squamous cancer

Oral squamous cancers constitute a large proportion of head–neck malignancies in India. One subset of oral cancers includes lesions arising in the oral commissure and the mucosa around it. These are unique in their location and pattern of spread with even small lesions affecting oral competence, function, and cosmesis. This study was done to analyse such “pericommissural” cancers and to explore if they should be placed in a distinct subcategory of buccal cancers with different implications for management and prognostication. 25 cases of pericommissural squamous cancers were studied. Presentation, extent, differentiation, nodal metastases, and treatment outcomes were evaluated. Cancers of the pericommissure made up 8.7% of oral cancers that were treated surgically between 2013 and 2015. All cases underwent upfront surgery with neck dissection and reconstruction with local flaps. 36% cases were staged pT4; 12% cases had nodal involvement. 40% patients received adjuvant treatment. After a median follow-up of 676 days, there were no recurrences. Five patients died of unrelated causes and one patient died of a second primary in the lung. Functional and cosmetic outcomes were measured objectively as well as subjectively; patient expectations were taken into consideration and the scores were satisfactory. Pericommissural squamous cancers show a distinct behaviour and it may be helpful to place these lesions in a separate subcategory of oral cancers. Functional and cosmetic aspects are as important in their management as is disease control.

Correlation Between β-Catenin Expression and Staging in Nasopharyngeal Carcinoma Patients.

Nasopharyngeal carcinoma (NPC) is a malignant disease derived from nasopharyngeal epithelial cells that have a higher tendency for invasion and metastasis to the cervical lymph nodes than other head-neck malignancies. NPC patients with the same stages often show different progressions and prognoses. This suggests that clinical stages are not sufficient to predict progressivity, so biomarkers are required to provide better progression predictions. Some literature shows that the development and progression of NPC is a complex mechanism involving various components of signal paths, it plays a role in regulating the process of proliferation, angiogenesis and apoptosis. One of the most studied is β-catenin protein that is a key component of the canonical Wnt signal pathway. The β-catenin protein is reported to have roles in increasing the proliferative pathway of c-Myc and cyclin D1, increasing the expression of IL-8 proangiogenesis factor, decreasing expression of RASSF1A tumor suppressor and inhibiting apoptosis through the barriers of caspace-9 activity. To determine the association of β-catenin expression and staging in nasopharyngeal carcinoma patients. The research design used was analytic observational research with cross sectional approach. Samples were enrolled using consecutive sampling. The β-catenin expression was examined from the NPC tissue paraffin block with the immunohistochemical cracking technique, using an anti-β-catenin rabbit polyclonal antibody from Boster Biotechnology, California, USA. The β-catenin expression was assessed visually using a binocular light microscope and a scoring method according to the Allred scale index by an Anatomical Pathology consultant. Statistical analysis was performed using Spearman's test to determine the association between β-catenin expression and staging in NPC patients. The significance level was α = 0.05. The study was conducted from May to December 2015 at Otolaryngology Unit of Dr. Soetomo General Soetomo, Surabaya. There were 40 patients who fulfilled the inclusion criteria. Spearman test results obtained p value = 0.060. The correlation of β-catenin expression with staging in NPC patients was found to be non-significant (p > 0.05). There was no correlation between β-catenin expression and staging in NPC patients.

PO-057: Radiation induced skin reaction in head neck malignancies and assessment of quality of life

PO-057: Radiation induced skin reaction in head neck malignancies and assessment of quality of life

Nodal Metastasis in Neck: A Clinical Study of 60 Cases

Introduction: An enlarged neck node is frequently the first clinical manifestation of a neoplastic process in the head and neck region. The earlier the diagnosis is made, the greater the chance of improved survival. A common denominator to all head-neck malignancy is their ability to metastasize. Although metastasis is not a random event, some tumours have the propensity to extensive local invasion without metastasis whereas others metastasize early in their development.&#x0D; Objective: To evaluate the different primary sites metastasizing to cervical lymph nodes.&#x0D; Materials and Methods: A prospective observational study was carried out from July 2007 to March 2009 in the department of Otolaryngology and Head-Neck Surgery, Combined Military Hospital, Dhaka among 60 patients who had metastatic neck nodes with known primary in head-neck region and those with unknown primary were included in this study. Metastatic neck disease involving left supraclavicular or scalene nodes with a possible primary arising within the chest or abdomen were excluded from the study. All cases were advised for Fine Needle Aspiration Cytology (FNAC) of enlarged neck nodes. Tissue samples were taken from primary sites for histopathology.&#x0D; Results: Metastatic neck disease is commonly encountered in Bangladesh. A primary lesion was identified in 53(88.33%) cases however primary sites found undetected in 7(11.67%) cases. Among the primary sites 43(81.13%) cases were seen to arise from squamous lining of upper aero-digestive tract and 10(18.87%) cases were having a nonsquamous origin arising from thyroid gland (13.33%) and parotid gland (3.33%). Among the known primary sites highest incidence of metastatic neck nodes was found with carcinoma- larynx 22(36.66%) and pyriform fossa in 9(15%) cases. Forty seven (78.33%) patients were male and 13(21.67) were female with ratio being 3.6:1 of ages ranging from 20 years to 90 years.&#x0D; Conclusion: Metastatic neck disease in commonly encountered in Bangladesh. Enlarged cervical nodes in an elderly patient should always be considered as metastatic until proved otherwise.&#x0D; Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 56-59

Comparative study on complications of emergency and elective tracheostomy

Background: Both elective and emergency tracheostomy as life saving procedure is frequently performed. Tracheostomy can be associated with numerous (per operative and post operative) complications.Methods: this was a cross sectional study 120 patients were studied age ranged from 9 years to 79 years in four different tertiary hospitals in Dhaka from July 2011 to June 2013.Results: Among 120 tracheostomized patients, 75 (62.5%) were patients of emergency tracheostomy group and 45 (37.5%) were patients of elective tracheostomy group. Laryngeal carcinoma and other head-neck malignancy were the common (67.34%) indications for emergency tracheostomy. Maxillofacial and laryngeal surgery (50.1%) was the common indications for elective tracheostomy. Haemmorage was the most common complication. The second most common complication were subcutaneous surgical emphysema and wound infection , Then tube displacement, pericondritis and stomal stenosis/ granulation tissue formation were the complications . In all stages (peroperative, immediate postoperative, early postoperative and late postoperative), the frequency of complications was more in emergency tracheostomy and it was statistically significant (p&lt;0.05).Conclusion: Complications are more in emergency than elective tracheostomy. To reduce complications should be aim of all types of tracheostomyBangladesh J Otorhinolaryngol; October 2015; 21(2): 69-75

Lymph Node Staging in Patients of Head &amp; Neck Malignancies with Clinically Negative Neck Examinations by Ultrasound and Ultrasound Guided Aspiration Cytology

Head and neck cancer is very common with incidence rates varying from 10-15% in various sociodemographic regions and approximately 50% of all malignant tumours in males in India. More than 90% of head neck cancers are squamous cell carcinomas with variety of malignant tumours. Clinical examination (Palpation) can miss the detection of lymph nodes in up to 60% of cases. In head and neck cancers, spread to the lymph nodes in the neck is relatively common and most important factor in determining the survival of patients with head neck cancer at any site depends on the metastatic disease in the neck. Size of lymph node is about 2-3 mm which normally can’t be palpated. High resolution ultrasound can detect these nodes which are clinically not palpable and is non-invasive harmless procedure. Because of safety of ultrasound and ultrasound guided FNAC, the procedure is likely to be used in every patient of head neck malignancies, more wide spread use would result in better planning for management of metastatic lymph nodes of neck and better care of patient by decreasing the morbidity, mortality and cost associated with unnecessary surgery by avoiding the need for other diagnostic procedures. So it is suggested that in every patient of head and neck malignancy after clinical examination ultrasound with and /or without FNAC should be done as a mandatory procedure for the better management of the patient.

Dermatological side effects of epidermal growth factor receptor inhibitors: ′Pride′ complex

Epidermal growth factor receptor (EGFR) inhibitor therapy has become the standard treatment for non-small cell lung cancer and head neck malignancy. This class of drug comprises EGFR inhibitors (erlotinib and gefitinib) and monoclonal antibody (cetuximab). Use of this class of drugs has been associated frequently with dermatological side effects termed as PRIDE complex–Papulopustules and/or paronychia, Regulatory abnormalities of hair growth, Itching, Dryness due to EGFR inhibitors. We hereby report the cutaneous side effects of EGFR inhibitor therapy in 15 patients of lung and head/neck cancer. The major clinical findings being acneiform eruption and severe xerosis of skin. Management of these dermatological adverse effects rarely requires discontinuation of targeted therapy and can be managed symptomatically.