Severity Of Skin Reactions Research Articles

Thermovisiographic Study of Epicutaneous Testing with Dental Haptens in Different Concentrations

Dental haptens are used to study sensitization to their respective dental materials. The concentration of haptens is important for the diagnostic process, as different concentrations lead to different severity of skin reactions. The aim of the study was to examine the dermal reactivity to 15 dental haptens in two different concentrations after the Patch test, by thermal imaging and calculating the temperature parameters of the respective reactions. The present study included 15 haptens from five different categories of dental materials, each with two different concentrations, with the objective to examine the results ensuring the Patch test. Thirty-three patients were included in the study. A total of 990 skin reactions were observed. They were subject to standard and thermal imaging evaluation. Approximately 5% of reactions were positive. The thermovisiographic indicator `dT' confirms the results of the standard readings, as its values vary from 0 to 0.8 ⁰C in the case of positive reactions. The study observed no significant differences in the results based on gender, both in the standard and in the thermal imaging examination. The study also confirms that it is necessary to apply certain concentrations of each hapten depending on its nature.

Analysis of the Effect of Radiotherapy Skin Protective Agents on Skin Reactions in Patients with Nasopharyngeal Carcinoma Radiotherapy

Objective: To analyze the application effect of radiotherapy skin protective agents on skin reactions in patients with nasopharyngeal carcinoma radiotherapy. Methods: One hundred and twenty nasopharyngeal cancer patients admitted to the hospital from January 2017 to January 2023 were randomly divided into a control group and an observation group of 60 cases each. Both groups received radiotherapy. The control group received traditional intervention methods while the observation group received traditional intervention methods combined with radiation therapy and skin protective agent intervention. The skin reactions, pain, comfort, and quality of life were compared between the two groups. Results: Both groups of patients had skin reactions, but the severity of skin reactions in the observation group was lower than that in the control group (P < 0.05). On the last day of radiotherapy, the pain score of the observation group was lower than that of the control group, and the comfort score was higher than that of the control group (P < 0.05). The total quality of life scores of the patients in the observation group were higher than those in the control group (P < 0.05). Conclusion: In treating skin reactions in patients with nasopharyngeal carcinoma undergoing radiotherapy, the application of radiotherapy skin protective agents reduced skin damage and pain and increased their quality of life.

Clinician- and Patient-Reported Outcomes with Tirbanibulin 1% Treatment for Actinic Keratosis in Routine Clinical Practice Across the U.S. (PROAK Study)

Background: Patients' experiences regarding topical actinic keratosis (AK) treatments may optimize clinical outcomes. PROAK study aimed to evaluate patient- and clinician-reported outcomes among adult patients with AK on face or scalp who were prescribed tirbanibulin in real-world clinical practice in the United States.
 Methods: Key primary endpoint was quality of life (QoL) assessed by Skindex-16. Additional endpoints were tirbanibulin treatment effectiveness and satisfaction (Treatment Satisfaction Questionnaire for Medication and Expert Panel Questionnaire).
 Results: 290 patients were included in this analysis. At week 8, Skindex-16 scores improved in all domains (mean change from baseline [standard deviation, SD]: -14.3 [27.8] in symptoms, -24.9 [33.0] in emotions, and -9.8 [23.7] in functioning domain). Clinicians and patients reported high global satisfaction with tirbanibulin (mean [SD] scores of 78.8 [20.1] and of 74.5 [23.5]). Overall skin appearance improved from baseline to week 8 (91.0% clinicians; 84.1% patients). In comparison with previous treatments, tirbanibulin had shorter skin reactions duration (89.2% clinicians; 73.9% patients); milder skin reaction severity (91.0% clinicians; 76.6% patients); better daily activities impact (87.4% clinicians; 64.0% patients); and was easier to use (88.3% clinicians; 71.2% patients). Investigator’s Global Assessment (IGA) success (0-1) was achieved by 73.8% of the patients. Skin photodamage severity reduction from baseline to week 8 was significant (77.4% vs. 39.6%; p<0.0001).
 Conclusions: Tirbanibulin treatment demonstrated effectiveness in AK management. Moreover, tirbanibulin improved QoL, as early as week 8, and both clinicians and patients reported tirbanibulin treatment convenience, and high levels of treatment satisfaction, compared to patient’s previous treatments.

Personal protective equipment and adverse dermatological reactions among healthcare workers: Survey observations from the COVID-19 pandemic.

The pandemic of the 2019 novel coronavirus disease (COVID-19) has caused an unprecedented mobilization of the United States’ healthcare workforce. In addition to working extended hours under increased duress, healthcare professionals (HCP) of all stations have been making use of various types of personal protective equipment (PPE) with greatly increased frequency and duration. Current data regarding adverse skin reactions as a possible consequence of PPE use are, particularly in the United States, largely insufficient for policy-makers to make informed decisions regarding daily PPE use among HCP.The research vehicle employed by this study is a cross-sectional 25-item survey distributed via email to workers currently employed by a five-hospital system in southcentral Kentucky. This survey was used to collect information from hospital workers of all professional roles about their experiences during the COVID-19 pandemic, focusing on reports of adverse dermatological reactions and associated risk factors.Out of 879 respondents, 54.4% reported some type of skin irritation reaction. Skin irritation was significantly more prevalent among medical and medical support staff than non-medical hospital workers, with the highest prevalence among Certified Nurse Assistant (CNAs). Among clinical workers, those in dedicated COVID-19 units reported the highest prevalence of adverse skin reaction. The most common complaint was dryness/scaling of the skin (306 out of 439, 69.7%), and the most common location was the facial cheeks (305 out of 516, 59.1%). Among those who reported skin irritation, the average self-reported severity of skin reaction (on a scale of 1–5) was 2.00 ± 0.05, and the mean total days of skin reaction per month was 11.70 ± 0.39 days. Total days of irritation per month was found to be significantly related to “total days of PPE use per month,” “hours of PPE use per day,” “frequency of hand washing,” and “use of disinfecting UV irradiation.” Severity of skin reaction was found to be significantly related to “hours per day of PPE use,” “consecutive days of PPE use,” and “female sex.”Clinical workers that put in the most face-to-face time with patients, and those in dedicated COVID-19 units, had the highest risk of adverse skin reaction. Overall, skin reactions were found to be mild, even in those hospital workers with the heaviest PPE use. Because the widespread and consistent use of facial masks in public settings has become a key tool in our protracted struggle with SARS-CoV-2, these findings may help to ameliorate concerns that everyday facial mask and/or other PPE usage contributes to significant dermatologic morbidity among both medical professionals and public citizens.

Prophylaxis and Management of Radiation-Induced Dermatitis

Radiation dermatitis is an acute skin reaction that occurs as a result of radiotherapy used to treat a range of different cancers. The severity of symptoms ranges from erythema to dry desquamation (dry, flaky skin with itching) to moist desquamation (serious exudate, edema, and blistering). While a variety of topical agents and dressings are used to ameliorate side effects, there is minimal evidence to support their use. This study aimed to review the evidence on radiation-induced dermatitis, its prophylaxis, and its management. Only a few studies have found that specific topical agents have a significant benefit. Film dressings are the most efficient means of preventing acute radiation dermatitis, whereas foam dressings were found to be beneficial in treating it. In a preventive situation, barrier films and silicone-based gel treatments may lower the severity of skin reactions and symptoms and entirely halt the onset of moist desquamation. Radiation dermatitis has been prevented and treated with a variety of topical and systemic medications, but there is not enough data to recommen

Intensity of Local Skin Reactions During 5-Fluorouracil Treatment Related to the Number of Actinic Keratosis Lesions: A Post Hoc, Exploratory Analysis

IntroductionActinic keratoses (AK) are epithelial lesions caused by chronic skin exposure to ultraviolet light that can progress into squamous cell carcinoma. Although several treatments are effective, they are associated with severe skin reactions, which might be related to the extent of the disease. This study aimed to examine the relationship between the severity of local skin reactions during treatment with 5-fluorouracil 4% cream and the number of AK lesions at baseline.MethodsThis post hoc analysis pooled data from two multicentre randomised phase III studies (HD-FUP3B-048, HD-FUP3B-049) in patients with AK treated with topical 5-fluorouracil 4% once daily (OD) or 5% twice daily (BID) for 4 weeks. First, we compared the severity, assessed using a numerical rating scale, of the local skin reactions between 5-fluorouracil 4% and 5%. Then, we investigated the relationship between the number of lesions at baseline and severe skin reactions with 5-fluorouracil 4% OD.ResultsSafety data were included from 397 patients who had received 5-fluorouracil 4% (348 in study HD-FUP3B-048, 49 in study HD-FUP3B-049) OD and 342 (HD-FUP3B-048) who had received 5-fluorouracil 5% BID. For most skin reactions, severe ones were more common in patients treated with 5-fluorouracil 5% cream BID than in those treated with 5-fluorouracil 4% cream OD (P < 0.05). With 5-fluorouracil 4% OD, the incidence of severe erythema was significantly higher in patients with at least 10 lesions (46%) than in patients with 5–10 lesions (28%; P < 0.001). Similar results were observed for the other local skin reactions.ConclusionTreatment with 5-fluorouracil 4% cream OD was associated with less severe local skin reactions than 5-fluorouracil 5% BID. The number of AK lesions at baseline seems to have predictive value regarding the severity of local skin reactions that appear during treatment.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13555-021-00668-9.

Intradermal Testing Identifies 1 in 4 Patients with Nonimmediate Penicillin Allergy

Background: Intradermal testing with delayed reading (IDTdr), used routinely in many centers, may identify delayed reactions to penicillins. However, few studies have compared the results of IDTdr with drug provocation test (DPT). The aim of this study was to examine the proportion of provocation-positive patients testing positive on IDTdr. Methods: Fifty-seven patients with a positive DPT occurring >2 h after intake of penicillin V, dicloxacillin, pivampicillin, or amoxicillin had an IDTdr with penicillin G, amoxicillin, ampicillin, and dicloxacillin. A control group included 18 patients with negative DPTs with the suspected penicillin. Results: In total 25% (n = 14) of provocation-positive patients tested positive on IDTdr. Among patients with positive IDTdr, 9/14 (64%) versus 11/43 (26%) in the IDTdr negative group (p < 0.05) had required oral steroids to treat skin reactions following DPT. No other differences between IDTdr positive and negative groups were found. No controls had a positive IDTdr. Conclusion: Investigating with IDTdr would have identified 25% of patients with a DPT-verified allergy with delayed reactions. It is difficult to target subgroups who will test positive on IDTdr. There were more patients who tested positive on IDT who had received oral steroids after DPT, and this may be an indication that skin reaction severity plays a role in skin testing diagnostics. Further potential predictors for positivity of IDTdr, such as duration of skin symptoms, should be assessed in large studies in order to optimize the investigations of nonimmediate drug allergic reactions.

Photobiomodulation therapy for the prevention of acute radiation dermatitis in head and neck cancer patients (DERMISHEAD trial)

Background and purposeThe purpose of this study was to investigate the effectiveness of photobiomodulation therapy (PBMT) for the prevention of acute radiation dermatitis (ARD) in head and neck cancer (HNC) patients. Materials and methodsA randomised, placebo-controlled trial (RCT) with 46 HNC patients who underwent radiotherapy (RT) with or without concomitant chemotherapy was set up (DERMISHEAD trial). Patients were randomised to receive PBM or placebo treatments from the first day of RT (2×/week) alongside the institutional skincare. The severity of skin reactions was assessed by the National Cancer Institute-Common Terminology Criteria for Adverse Events version 4.03 (NCI-CTCAE v4.03) and the Radiotherapy-Induced Skin Reaction Assessment Scale (RISRAS). Quality of life (QoL) was evaluated using the Skindex-16 questionnaire. ResultsPBMT significantly reduced NCI-CTCAE grade 2–3 ARD with 49% at the end of RT. ConclusionThe results of the first RCT in HNC patients showed that PBMT is an effective method to prevent the development of severe ARD. These results support the implementation of PBM in the clinical oncology – radiotherapy practice.

Comparing Accuracy of Thermoplastic Mask versus Commercial Bra for the Immobilization of Pendulous Breast During Radiation Therapy Treatment: A Retrospective Cohort Study

PurposeThis study aimed to compare thermoplastic mask with bra in terms of setup reproducibility and immobilization of pendulous breasts during radiation therapy (RT). Methods and materialsForty-two female patients with breast cancer treated with either intensity modulated RT or 3-dimensional conformal RT were retrospectively reviewed. Of these, 21 benefited from thermoplastic mask immobilization and 21 used a bra. Setup accuracy was evaluated using consecutive cone beam computed tomography/electronic portal imaging device sessions over the first 3 days before treatment (systematic setting), followed by weekly cone beam computed tomography/electronic portal imaging device (random settings), and compared with the reference image to calculate the corresponding translational shift (setup error) in the 3 planes. Average absolute shift values in both systematic and random settings were compared between the 2 groups. Accuracy was analyzed by comparing the percentage of pooled settings within ±0.05 and ±0.1 cm of the reference image. ResultsCompared with a bra, use of the mask was associated with a smaller longitudinal shift in systematic settings (difference in mean: 0.27 cm; P = .027; Mann-Whitney U test) and a lesser lateral shift in random setting (difference in mean: 0.19 cm; P = .005; Mann-Whitney U test). In the pooled systematic settings, the mask performed relatively better than the bra in the lateral and longitudinal planes, with no statistical significance. In pooled random settings, mask showed greater accuracy than bra in the lateral plane with 86.0% versus 58.9% accuracy at ±0.5 cm (P < .001) and 48.8% versus 21.7% accuracy at ±0.1 cm (P < .001), respectively. There was no significant difference in the incidence of radiodermatitis between the 2 groups. However, a hypofractionation regimen was associated with a lower incidence of radiodermatitis, and the severity of skin reactions was positively correlated with treatment dose (unstandardized regression coefficient: B = .001; correlation coefficient: r = .571; P < .001). ConclusionsMasks provide superior reproducibility compared with commercially available bras.

Mepitel Film is superior to Biafine cream in managing acute radiation-induced skin reactions in head and neck cancer patients: a randomised intra-patient controlled clinical trial.

IntroductionWe previously showed that Mepitel Film decreased the severity of acute radiation‐induced skin reactions in head and neck cancer patients. In the current study, we compared the effect of Mepitel Film and Biafine cream on skin reaction severity in a larger cohort of head and neck cancer patients.MethodsA total of 44 head and neck cancer patients were recruited with 39 patients contributing full data sets for analysis. Patients received a dose of 50 Gy in 25 fractions to the bilateral lymph nodes in the neck. Left and right lymph node areas were randomised to either Mepitel Film or Biafine cream, applied prophylactically. Skin reaction severity was measured using Radiation‐Induced Skin Reaction Assessment Scale (RISRAS) and expanded Radiation Oncology group (RTOG) grades. Skin dose was measured using gafchromic Film.ResultsSkin reaction severity (combined RISRAS score) underneath Mepitel Film was decreased by 30% (P < 0.001) and moist desquamation rates by 41% (P < 0.001). Skin dose underneath Mepitel Film and Biafine cream was similar (P = 0.925) and unlikely to have affected skin reaction severity. The vast majority (80%) of patients preferred Mepitel Film over Biafine cream. Negative aspects of Mepitel Film included poor adherence (11/39) and discomfort (16/39) during hot weather and showering and itchy skin underneath Mepitel Film (12/39).ConclusionsMepitel Film was superior to Biafine cream in reducing the severity of acute radiation‐induced skin reactions and moist desquamation incidence in our head and neck patient cohort.

An audit of radiation-induced skin reactions in the inframammary fold; does breast size impact on the severity of the reaction?

IntroductionSkin toxicity is a clinically significant side effect of external beam radiation; moist desquamation is particularly prevalent for breast patients, mainly in the axilla and inframammary fold (IMF). The aim of this audit was to assess if there is a correlation between patient breast size and the presence and extent of radiotherapy skin reaction in the IMF. MethodsBetween 22/12/2017 and 31/05/2018 forty patients undergoing standard whole breast radiotherapy using 3D planned medial and lateral tangential fields had their skin reaction recorded weekly, whilst on treatment, using the Radiotherapy Oncology Group (RTOG) scoring system. Skin reactions were also documented at three and eight weeks post radiotherapy. A measurement of the patients IMF length and bra size were also noted. Statistical analysis was carried out using IBMÒ SPSS Statistics 24. ResultsSix patients presented with grade ≥2 during week three of radiotherapy. The mean IMF length of six patients with adverse reactions 6.1 cm (±3.6 cm). As the length of the IMF increases, severity of skin reactions also increases; a positive correlation was identified between the two at both week three of radiotherapy and three weeks post radiotherapy (r = 0.401, n = 34, p = 0.05 and r = 0.671, n = 29, p = 0.00 respectively). Only one patient displayed grade 2 at eight weeks post radiotherapy (IMF length 7.5 cm). ConclusionThe findings from this study would suggest that larger breasted patients do present earlier, and with more severe radiation-induced skin reactions. Implications for practiceChanges to skin care practice could be considered for patients with larger breasts. This could be in the form of more frequent check-ups during treatment or proactive side effect management rather than reactive management.

576P - Impact of prophylactic systemic antibiotics (SA) on outcome of patients (pts) with RAS-wildtype (RAS-wt) metastatic colorectal carcinoma (mCRC) treated with cetuximab-based first-line therapy. Subgroup analysis of the german non-interventional study ERBITAG

BackgroundSA are widely used and recommended to ameliorate skin reactions induced by EGFR inhibition. Randomised studies have shown a positive impact of SA on severity of skin reactions, but the influence on outcome are widely unknown. Recent data suggests that antibiotics negatively influence the efficacy of checkpoint-inhibitor therapies. Therefore, an evaluation of the impact of SA on the outcome of RAS-wt mCRC pts treated with cetuximab-based therapy is highly needed. MethodsPts with RAS-wt mCRC treated with a cetuximab-based first-line combination and written informed consent were eligible for this prospective, non-interventional study. According to a thorough questionnaire about prophylactic treatments for skin management, pts were categorized in 2 groups: SA and no SA. Outcome endpoints like objective remission rate (ORR), progression free survival (PFS), overall survival (OS), and time to treatment failure (TTF) were compared between the two subgroups. ResultsData from 583 of 875 enrolled pts were evaluable at the data cut-off (SA: n=183; no SA: n=400). Pts were not included for the following reasons: no cetuximab therapy (34), not fully documented (131), no first-line therapy (95), no RAS-wt (2), and no skin questionnaire (30). Pts in the SA group showed compared to the no SA group a significantly increased median PFS with 12.30 vs 9.51 months (p=0.033) and OS with 28.22 vs. 20.79 months (p=0.0063). Number of cetuximab infusions were numerically higher in the SA group (mean: 30.6 vs 27.4, p=0.0581), as well as ORR with 63.9% and 56.5% (p=0.09) and TTF with 5.46 vs 4.61 months (p=0.0746), but all three endpoints did not reach significance. In a multivariate analysis the impact of SA was an independent significant factor on OS (p<0.05), but not on PFS (p=0.09). ConclusionsData of this large non-interventional trial suggests that SA have a positive impact on the OS outcome of RAS-wt mCRC pts treated with a cetuximab-based first-line therapy. Hence, the data supports the recommendations for SA in the treatment management of EGFR inhibitors in mCRC. Editorial acknowledgementFelix Eilenberger, Alcedis GmbH, Gießen, Germany. Legal entity responsible for the studyMerck Serono GmbH, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany. FundingMerck Serono GmbH, Darmstadt, Germany, an affiliate of Merck KGaA, Darmstadt, Germany. DisclosureS.W. Sahm: Shareholder / Stockholder / Stock options: Merck KGaA; Honoraria (self): Fresenius Kabi; Research grant / Funding (institution): Merck Serono GmbH. M. Zahn: Honoraria (self): Merck Serono GmbH. J. Janssen: Advisory / Consultancy, Research grant / Funding (self): Bayer; Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy, Research grant / Funding (institution): Bristol-Myers Squibb; Advisory / Consultancy, Research grant / Funding (institution): Novartis; Advisory / Consultancy, Research grant / Funding (institution): Roche; Advisory / Consultancy, Research grant / Funding (institution): Sanofi; Advisory / Consultancy, Research grant / Funding (institution): PharmaMar; Research grant / Funding (institution): Amgen; Research grant / Funding (institution): Onyx; Research grant / Funding (institution): Baxter; Research grant / Funding (institution): Biotest; Research grant / Funding (institution): Celgene; Research grant / Funding (institution): Janssen Cilag Ltd; Research grant / Funding (institution): Kedrion Biopharma; Research grant / Funding (institution): Eli Lilly; Research grant / Funding (institution): Merck Serono GmbH; Research grant / Funding (institution): Octapharma; Research grant / Funding (institution): Pfizer; Research grant / Funding (institution): Puma Biotechnology; Research grant / Funding (institution): Teva Pharmaceutical; Research grant / Funding (institution): AbbVie; Research grant / Funding (institution): Ipsen; Research grant / Funding (institution): Servier. C. Hering-Schubert: Honoraria (self): Novartis; Honoraria (self), Advisory / Consultancy: Amgen; Honoraria (self): Sanofi. I. Zander: Advisory / Consultancy: Boehringer Ingelheim; Honoraria (self): Pfizer; Honoraria (self): Mundipharma; Travel / Accommodation / Expenses: Bristol-Myers Squibb; Travel / Accommodation / Expenses: Novartis; Travel / Accommodation / Expenses: Ribosepharm; Travel / Accommodation / Expenses: Merck Serono GmbH. K.G. Stenzel: Full / Part-time employment: Merck Serono GmbH; Shareholder / Stockholder / Stock options: Merck KGaA. F. Overkamp: Leadership role, Full / Part-time employment: OncoConsult. Hamburg GmbH; Leadership role, Full / Part-time employment: onkowissen.de GmbH; Honoraria (self), Advisory / Consultancy: Amgen; Honoraria (self), Advisory / Consultancy: Bayer; Honoraria (self): AstraZeneca; Honoraria (self), Advisory / Consultancy: Bristol-Myers Squibb; Honoraria (self), Advisory / Consultancy: Boehringer Ingelheim; Advisory / Consultancy: Cellex; Advisory / Consultancy: ClinSol; Honoraria (self), Advisory / Consultancy: Gilead; Advisory / Consultancy: Hexal; Honoraria (self), Advisory / Consultancy: Iomedico; Honoraria (self), Advisory / Consultancy: Merck Sharp & Dohme; Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: Riemser; Advisory / Consultancy: Roche; Advisory / Consultancy: Tesaro; Advisory / Consultancy: Teva; Honoraria (self): Chugai; Honoraria (self): Celgene; Honoraria (self): Eisai; Honoraria (self): Ipsen; Honoraria (self): Janssen-Cilag; Honoraria (self): Merck Serono GmbH; Honoraria (self): Novo Nordisc; Honoraria (self): Servier; Honoraria (self): Shire. All other authors have declared no conflicts of interest.

Abstract P3-12-11: Prophylactic application of SkinSafe film strips to the inframammary fold prevents moist desquamation during irradiation for breast cancer in a prospective trial

Abstract Purpose: To investigate the effect of prophylactic use of SafeSkin films strips applied to the inframammary fold during whole breast or reconstructed breast irradiation to avoid moist desquamation to the inframammary fold. Materials and Methods: Between November 15, 2016 and April 17, 2018, a total of 30 patients were recruited, with 29 patients contributing to analysis, and one patient with bilateral breast cancer. Areas of the breast treatment field not covered by the film were treated with physician's choice of cream, (80% Jean's Cream, 13% Aquafor, and 7% with no topical therapy). The treatment field was photographed weekly. SkinSafe strips were reapplied as needed, but were not applied if erythema was already observed in the inframammary fold. Severity of skin reaction was assessed using the RTOG scale. Results: There was only one treatment interruption, against medical advice, due to axillary discomfort. One patient refused further trial participation after the first day. No short or long term side effects of film use were noted. Inframammary desquamation developed in only one patient, who tried to replicate the increased comfort of her inframammary tape with adhesive bandages when her tape came off. There was no moist desquamation under the SkinSafe film in the inframammary field in any patient. Axillary moist desquamation, where no film, but rather physician's choice of topical cream was applied, remained at 35%. Areas of skin adjacent to the SkinSafe film showed desquamation in 9.7% of patients, 0.5-1 cm in maximal diameter, all of which had resolved at time of completion. Conclusions: Prophylactic use of SkinSafe film strips applied to the inframammary fold substantially reduces or eliminates the risk of inframammary desquamation during breast radiation. Citation Format: Garren D, Le B, Vasireddy R, Flynn L, Forster K, Malina L, Dorfman Y. Prophylactic application of SkinSafe film strips to the inframammary fold prevents moist desquamation during irradiation for breast cancer in a prospective trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-12-11.

UJI IRITASI SEDIAAN GEL ANTIJERAWAT FRAKSI LARUT ETIL ASETAT EKSTRAK ETANOL DAUN BINAHONG (Anredera cordiofolia (Ten.) Steenis) PADA KELINCI

&lt;pre&gt;&lt;em&gt;Gel is a pharmaceutical preparation with good penetration power and long contact time with skin so it can overcome the problem of acne&lt;/em&gt;&lt;em&gt;. &lt;/em&gt;&lt;em&gt;Gelling agent is the main ingredient in gel preparation. &lt;/em&gt;&lt;em&gt;Skin irritation test &lt;/em&gt;&lt;em&gt;is an important part of the pharmaceutical preparation procedures&lt;/em&gt;&lt;em&gt;. &lt;/em&gt;&lt;em&gt;In Material Safety Data Sheet states that Hydroxy Propyl Methyl Cellulose (HPMC) and Carbopol can cause skin irritation problems.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;The aim of this research is to find out whether gel preparation of the active fraction of ethanol extract of binahong lea&lt;/em&gt;&lt;em&gt;ve&lt;/em&gt;&lt;em&gt; with combination of gelling agent Hydroxy Propyl Methyl Cellulose (HPMC) and carbopol can cause irritation on rabbit skin.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;The irritation test was performed by Draize method on three New Zealand male rabbits who had shaved the back part 24 hours prior to treatment. The irritant samples were smeared and then covered with sterile gauze and glued with plaster&lt;/em&gt;&lt;em&gt;. &lt;/em&gt;&lt;em&gt;Observations were made after 24, 48 and 72 hours after administration of the test material. Each area observed skin reactions that occur and scored 0 to 4 depending on the severity of skin reactions produced. Of the three gel preparation formulas, the score of degree of irritation was 1, 1 and 1.67, which means slight irritation (0.41-1.9).&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/pre&gt;&lt;strong&gt;&lt;em&gt;Keywords&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: binahong leave, gelling agent, irritation test.&lt;/em&gt;

The effect of Mepitel Film on acute radiation-induced skin reactions in head and neck cancer patients: a feasibility study.

Mepitel Film significantly decreases acute radiation-induced skin reactions in breast cancer patients. Here we investigated the feasibility of using Mepitel Film in head and neck cancer patients (ACTRN12614000932662). Out of a total of 36 head and neck cancer patients from New Zealand (NZ) (n = 24) and China (n = 12) recruited between June 2015 and December 2016, 33 patients complied with protocol. Of these, 11 NZ patients followed a management protocol; 11 NZ patients and 11 Chinese patients followed a prophylactic protocol. An area of the neck receiving a homogenous radiation dose of > 35 Gy was divided into two equal halves; one half was randomized to Film and the other to either Sorbolene cream (NZ) or Biafine cream (China). Skin reaction severity was measured by Radiation Induced Skin Reaction Assessment Scale and expanded Radiation Therapy Oncology Group toxicity criteria. Skin dose was measured by thermoluminescent dosimeters or gafchromic film. Film decreased overall skin reaction severity (combined Radiation Induced Skin Reaction Assessment Scale score) by 29% and moist desquamation rates by 37% in the Chinese cohort and by 27 and 28%, respectively in the NZ cohort. Mepitel Film did not affect head movements but did not adhere well to the skin, particularly in males with heavy beard stubble, and caused itchiness, particularly in Chinese patients. Mepitel Film reduced acute radiation-induced skin reactions in our head and neck cancer patients, particularly in patients without heavy stubble. Advances in knowledge: This is the first study to confirm the feasibility of using Mepitel Film in head and neck cancer patients.

Psychological stress affects the severity of radiation-induced acute skin reactions in breast cancer patients

Psychological stress exacerbates many pathological conditions including inflammatory skin conditions. The effect of psychological stress on acute radiation-induced skin reactions has not been documented before. Here, we aimed to explore if psychological stress could aggravate skin reaction severity in breast cancer patients. We conducted a secondary analysis of patient data obtained during a randomised, controlled clinical trial for acute radiation-induced skin reaction severity in 78 breast cancer patients. Patients were assessed three times a week during treatment. Skin reaction severity was measured using the modified Radiation-Induced Skin Reaction Assessment Scale (RISRAS) and Radiation Therapy Oncology Group grades. Stress levels were determined using a 5-point LIKERT scale to rate physical well-being, managing stress levels, house, family, work and other commitments. A total of 20 patients (26%) of the 78-patient cohort were considered stressed. Skin reaction severity in stressed patients was twice that of non-stressed patients (p<0.001) and stressed patients were five times more likely to develop moist desquamation. Our results show that psychological stress aggravates skin reaction severity during radiation therapy. This research needs to be validated in a more rigorous manner by incorporating a validated scale such as the Distress Thermometer and Impact Thermometer in future skin trials.

Recommendations for the Prophylactic Management of Skin Reactions Induced by Epidermal Growth Factor Receptor Inhibitors in Patients With Solid Tumors.

Epidermal growth factor receptor (EGFR) inhibitors extend patient survival across a variety of tumor types. The most common EGFR inhibitor-attributable adverse events are skin reactions. Prophylactic-rather than reactive-management of skin reactions for all patients receiving EGFR inhibitors should be recommended because appropriate prophylaxis could effectively reduce the severity of skin reactions; thus, the derivation of highly effective prophylactic strategies has the potential to directly benefit patients. Accordingly, a review of the available data leads to practical and evidence-based recommendations and algorithms regarding the optimal prophylactic management of EGFR inhibitor-attributable skin reactions.

Cutaneous toxic effects of targeted therapy: clinical manifestations and correction

Targeted therapy used in oncology today is the most effective, but frequent cutaneous side effects force to reduce dose or interrupt treatment, significantly reducing the anti-tumor effect. The data on the pathogenesis of toxic skin reactions and the most frequent clinical manifestations (papular-pustular reaction, hand-foot syndrome) according to various studies are presented. The basic principles of correction are described. Examples of anticancer drug doses correlation and severity of skin reactions are presented.

Diffuse Optical Spectroscopy for the Quantitative Assessment of Acute Ionizing Radiation Induced Skin Toxicity Using a Mouse Model

Acute skin toxicities from ionizing radiation (IR) are a common side effect from therapeutic courses of external beam radiation therapy (RT) and negatively impact patient quality of life and long term survival. Advances in the understanding of the biological pathways associated with normal tissue toxicities have allowed for the development of interventional drugs, however, current response studies are limited by a lack of quantitative metrics for assessing the severity of skin reactions. Here we present a diffuse optical spectroscopic (DOS) approach that provides quantitative optical biomarkers of skin response to radiation. We describe the instrumentation design of the DOS system as well as the inversion algorithm for extracting the optical parameters. Finally, to demonstrate clinical utility, we present representative data from a pre-clinical mouse model of radiation induced erythema and compare the results with a commonly employed visual scoring. The described DOS method offers an objective, high through-put evaluation of skin toxicity via functional response that is translatable to the clinical setting.

Diffuse Optical Spectroscopy for the Quantitative Assessment of Acute Ionizing Radiation Induced Skin Toxicity Using a Mouse Model.

Acute skin toxicities from ionizing radiation (IR) are a common side effect from therapeutic courses of external beam radiation therapy (RT) and negatively impact patient quality of life and long term survival. Advances in the understanding of the biological pathways associated with normal tissue toxicities have allowed for the development of interventional drugs, however, current response studies are limited by a lack of quantitative metrics for assessing the severity of skin reactions. Here we present a diffuse optical spectroscopic (DOS) approach that provides quantitative optical biomarkers of skin response to radiation. We describe the instrumentation design of the DOS system as well as the inversion algorithm for extracting the optical parameters. Finally, to demonstrate clinical utility, we present representative data from a pre-clinical mouse model of radiation induced erythema and compare the results with a commonly employed visual scoring. The described DOS method offers an objective, high through-put evaluation of skin toxicity via functional response that is translatable to the clinical setting.