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Melanoma pp 743-771 | Cite as

Cutaneous Adverse Events of Systemic Melanoma Treatments

  • Christian Menzer
  • Steven T. Chen
  • Gregory S. Phillips
  • Mario E. LacoutureEmail author
Reference work entry

Abstract

Cutaneous adverse events (AEs) are frequent with systemic melanoma treatments. As a result of a paradigmatic shift in melanoma management from traditional cytotoxic chemotherapy to immunotherapies and targeted therapies as first-line treatment, the spectrum of skin AEs to these treatments has significantly broadened. Cutaneous toxicities from anticancer therapy manifest as doubly burdensome as visible stigmatization often carries profound psychosocial implications. Early detection and treatment help to minimize a reduction in patients’ quality of life and maximize anticancer treatment adherence and outcome. The knowledge of typical presentations associated with the specific drug regimen administered to the patient is essential for timely management of these conditions. A dermatological evaluation of the skin condition appears to be essential for an interdisciplinary approach as very often even dramatic skin presentations do not necessitate a cessation of the potentially lifesaving antineoplastic drug. Since the onset of AEs of some therapies can take up to several months or years and may also occur in cancer survivors long after completion of their therapy, thorough dermatological follow-up may be advised even after successful completion of antineoplastic treatments.

Keywords

Cutaneous toxicities Immune checkpoint inhibitor (ICI) BRAF inhibitor (BRAFi) MEK inhibitor (MEKi) Chemotherapy Adverse events (AEs) 

Abbreviations

AD

Atopic dermatitis

ADLs

Activities of daily living

AE

Adverse event

AH

Antihistamines

AK

Actinic keratosis

BP

Bullous pemphigoid

BPAG

Bullous pemphigoid antigen

BRAF wt

BRAF wild-type mutation

BRAFi

BRAF inhibitor

BSA

Body surface area

CIA

Chemotherapy-induced alopecia

CsA

Cyclosporin A

CTCAE

Common Terminology Criteria for Adverse Events

CTLA-4

Cytotoxic T-lymphocyte antigen-4

cuSCC/SCC

(Cutaneous) Squamous cell carcinoma

DEJ

Dermo-epidermal junction

DRESS

Drug reaction with eosinophilia and systemic symptoms

DTIC

5-(3,3-Dimethyl-1-triazeno) imidazole-4-carboxamide

EGFRi

Epidermal growth factor receptor inhibitor

FDA

Food and Drug Administration

H&E

Hematoxylin and Eosin stain

HDAC

Histone deacetylase

HFS

Hand-foot syndrome

ICI

Immune checkpoint inhibitor

IDO

Indoleamine-pyrrole 2,3-dioxygenase

ircAE

Immune-related cutaneous adverse event

irAE

Immune-related adverse event

KA

Keratoacanthoma

LP

Lichen planus

MAPK pathway

Mitogen-activated protein kinase pathway

MEKi

MEK inhibitor

MMF

Mycophenolate mofetil

MTIC

5-3-Methyltriazen-1-yl-imidazo-4-carboxamide

MTX

Methotrexate

NSCLC

Non-small cell lung cancer

OS

Overall survival

OTC

Over-the-counter

PD-1

Programmed cell death protein-1

PD-L1

Programmed cell death ligand-1

PFS

Progression-free survival

QoL

Quality of life

RCC

Renal cell carcinoma

RR

Response rate

SCAR

Severe cutaneous adverse reaction

SJS

Stevens-Johnson syndrome

TCR

T-cell receptor

TEN

Toxic epidermolytic necrolysis

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Christian Menzer
    • 1
  • Steven T. Chen
    • 2
  • Gregory S. Phillips
    • 1
  • Mario E. Lacouture
    • 1
    Email author
  1. 1.Dermatology Service, Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Department of DermatologyMassachusetts General Hospital, Harvard Medical SchoolBostonUSA

Section editors and affiliations

  • Keith T. Flaherty
    • 1
  • Boris C. Bastian
    • 2
  • Hensin Tsao
    • 3
    • 4
  • F. Stephen Hodi
    • 5
    • 6
  1. 1.Henri and Belinda Termeer Center for Targeted TherapiesMGH Cancer CenterCambridgeUSA
  2. 2.Departments of Dermatology and Pathology, Helen Diller Family Comprehensive Cancer CenterUniversity of California, San FranciscoSan FranciscoUSA
  3. 3.AuburndaleUSA
  4. 4.Harvard-MIT Health Sciences and TechnologyCambridgeUSA
  5. 5.FraminghamUSA
  6. 6.Department of Medicine, Brigham and Women's HospitalDana-Farber Cancer InstituteBostonUSA

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