Hand-foot skin reaction induced by multitargeted tyrosine kinase inhibitors
- Mario E Lacouture, MD
Mario E Lacouture, MD
- Associate Professor of Medicine
- Cornell University
- Memorial Hospital
- Memorial Sloan Kettering Cancer Center
- Beth N McLellan, MD
Beth N McLellan, MD
- Assistant Professor
- Albert Einstein College of Medicine
- Section Editors
- Maja Mockenhaupt, MD, PhD
Maja Mockenhaupt, MD, PhD
- Section Editor — Drug Eruptions
- Professor of Dermatology
- Medical Center - University of Freiburg, Germany
- Jean-Claude Roujeau, MD
Jean-Claude Roujeau, MD
- Section Editor — Drug Eruptions
- Emeritus Professor of Dermatology
- Université Paris-Est Créteil (UPEC), Créteil, France
- Reed E Drews, MD
Reed E Drews, MD
- Section Editor — Complications of Cancer
- Associate Professor of Medicine
- Harvard Medical School
Protein tyrosine kinase inhibitors (TKIs), which include selective and multikinase inhibitors, are a class of targeted anticancer medications approved for treatment of a number of solid tumors. The ability of TKIs to block molecular pathways specific to the proliferation of malignant cells has decreased the incidence of many of the adverse events caused by cytotoxic chemotherapy. However, TKIs bring their own set of specific dermatologic adverse events, which include :
●Hand-foot skin reaction (HFSR)
●Seborrheic dermatitis-like eruption
●Subungual splinter hemorrhages
●Keratoacanthoma and squamous cell carcinomas
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- Risk factors
- Association of HFSR with survival
- CLINICAL MANIFESTATIONS
- IMPACT ON QUALITY OF LIFE
- Grading of severity
- DIFFERENTIAL DIAGNOSIS
- General principles
- - Treatment of hyperkeratosis and skin inflammation
- - Treatment of pain
- - Prevention of infection
- - Other
- Our approach
- - Patients with grade 1 rash
- - Patients with grade 2 rash
- - Patients with grade 3 rash
- SUMMARY AND RECOMMENDATIONS