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Journal of the American Academy of Dermatology
Volume 72, n° 2
pages 203-218 (février 2015)
Doi : 10.1016/j.jaad.2014.07.032
accepted : 22 July 2014
Continuing Medical Education

Cutaneous adverse effects of targeted therapies : Part I: Inhibitors of the cellular membrane

James B. Macdonald, MD a, b, , Brooke Macdonald, BA c, Loren E. Golitz, MD d, e, Patricia LoRusso, DO f, Aleksandar Sekulic, MD, PhD g
a Department of Dermatology, Central Utah Clinic, Provo, Utah 
b Department of Pathology, Central Utah Clinic, Provo, Utah 
c Macdonald Graphic Design, Inc, Provo, Utah 
d Department of Dermatology, University of Colorado-Denver, Aurora, Colorado 
e Department of Pathology, University of Colorado-Denver, Aurora, Colorado 
f Department of Oncology, Wayne State University, Detroit, Michigan 
g Department of Dermatology, Mayo Clinic, Scottsdale, Arizona 

Correspondence to: James B. Macdonald, MD, Departments of Dermatology and Pathology, Central Utah Clinic, 1055 N 500 W, Ste 111, Provo, UT 84604.

There has been a rapid emergence of numerous targeted agents in the oncology community in the last decade. This exciting paradigm shift in drug development lends promise for the future of individualized medicine. Given the pace of development and clinical deployment of targeted agents with novel mechanisms of action, dermatology providers may not be familiar with the full spectrum of associated skin-related toxicities. Cutaneous adverse effects are among the most frequently observed toxicities with many targeted agents, and their intensity can be dose-limiting or lead to therapy discontinuation. In light of the often life-saving nature of emerging oncotherapeutics, it is critical that dermatologists both understand the mechanisms and recognize clinical signs and symptoms of such toxicities in order to provide effective clinical management. Part I of this continuing medical education article will review in detail the potential skin-related adverse sequelae, the frequency of occurrence, and the implications associated with on- and off-target cutaneous toxicities of inhibitors acting at the cell membrane level, chiefly inhibitors of epidermal growth factor receptor, KIT, and BCR-ABL, angiogenesis, and multikinase inhibitors.

The full text of this article is available in PDF format.

Key words : adverse sequelae, alopecia, antiangiogenic agents, anticancer, BCR-ABL, bevacizumab, cancer treatment, canertinib, cetuximab, chemotherapy, cutaneous adverse effects, dasatinib, dermatologic toxicities, disturbed wound healing, drug eruption, drug rash, drug reaction, dry skin, dual kinase inhibitors, epidermal growth factor receptor inhibitors, erbB receptor, erlotinib, gefitinib, genital rash, HER2, hyperkeratotic hand–foot skin reaction, imatinib, KIT, lapatinib, macular eruption, monoclonal antibodies, morbilliform, mucocutaneous hemorrhage, mucositis, multikinase inhibitors, nilotinib, panitumumab, papulopustular eruption, paronychia, pazopanib, platelet-derived growth factor receptor, photosensitivity, pigment changes, ranibizumab, side effects, small molecule, sorafenib, stomatitis, sunitinib, supportive oncodermatology, targeted therapy, toxic erythema, tyrosine kinase inhibitors, vandetanib, vascular endothelial growth factor, xerosis

Abbreviations used : EGFR, HhSP, VEGFR

 Funding sources: None.
 Conflicts of interest: None declared.
 Date of release: February 2015
 Expiration date: February 2018

© 2014  American Academy of Dermatology, Inc.@@#104156@@