Original article
Taiwanese Dermatological Association consensus for the prevention and management of epidermal growth factor receptor tyrosine kinase inhibitor-related skin toxicities

https://doi.org/10.1016/j.jfma.2017.03.001Get rights and content
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Background/Purpose

This report describes the 2016 consensus of the Taiwanese Dermatological Association (TDA) regarding the definition, classification, diagnosis, prevention, and management of skin toxicities resulting from treatment with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). This consensus is distributed to practices throughout Taiwan to provide recommendations for the diagnosis and treatment of such skin toxicities in order to improve the quality of life of patients undergoing EGFR-TKI treatment. The consensus thus serves as an important reference for dermatologists and other interested clinicians, such as oncologists, throughout Taiwan.

Methods

All the consensus contents were voted on by the participating experts, with approval by no less than 75% required for inclusion.

Results

The consensus provides a comprehensive overview of EGFR-TKI skin toxicities, including recent advances in identifying their causes and the processes by which they develop.

Conclusion

All the consensus meeting attendees agreed that there are several major EGFR-TKI-related skin toxicities, including acneiform rash (i.e., papulopustular rash), xeroderma, pruritus, paronychia, stomatitis, mucositis, and hair changes (such as hair loss, slowed hair growth, and trichomegaly). The experts were also generally unanimous in their voting on the specific definitions, onset times, and care suggestions for each of those skin toxicities. Furthermore, the recommended treatment algorithms for the various skin toxicities were ultimately approved by 100% (15/15) of the consensus attendees.

Keywords

consensus
diagnosis
epidermal growth factor receptor
skin toxicities
tyrosine kinase inhibitors

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Conflicts of interest: Dr Chia-Yu Chu received consulting fees, travel support, and payment for lectures from Boehringer Ingelheim International GmbH and honoraria from AstraZeneca and Roche. Dr Kuan-Yu Chen received travel support from Boehringer Ingelheim and MSD, and payment for lectures from AstraZeneca, Roche, Eli Lilly, Boehringer Ingelheim, MSD, Bristol–Myers Squibb, SANOFI. Dr Chih-Hung Lee has conducted clinical trials for Janssen-Cilag Pharmaceutical, Novartis Pharmaceutical, and Roche Pharma; served as a consultant or received speaker fee, consulting fee, or travel support from AbbVie Inc., Janssen-Cliag Pharmaceutical, Pfizer Pharmaceutical, and Novartis Pharmaceutical. Drs John Wen-Cheng Chang, Yu-Feng Wei, Wei-Ming Wang declares no conflict of interest regarding this manuscript.