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09-12-2009 | Oncology | Article

Skin infection common in patients treated with EGFRIs

Abstract

Free abstract

MedWire News: Patients who experience dermatologic toxic effects from epidermal growth factor receptor inhibitors (EGFRIs) have a high prevalence of skin and nail infections, according to US researchers.

Treatment with EGFRIs frequently leads to dermatologic toxic effects, which can impact on patients’ quality of life and EGFRI dosing, note Mario Lacouture (Northwestern University Feinberg School of Medicine, Chicago Illinois) and colleagues.

However, the impact of these effects on the patients' physical health, including increased susceptibility to cutaneous infections, has not been ascertained.

To investigate, Lacouture and team collected data on 221 patients who were treated in a referral clinic for dermatologic toxic effects of EGFRIs. They examined associations between patient characteristics and the development of skin and nail infections recorded in the patients’ medical records.

The researchers report that 84 (38%) patients showed evidence of infection at sites of dermatologic toxic effect. The seborrheic region, which includes the scalp, face, neck and chest, was the most prevalent site of infection.

Bacterial infection was the most common infection subtype ,affecting 64 (29%) patients. Fifty (22.6%) patients had Staphylococcus aureus infection, 12 (5.4%) with methicillin-resistant S. aureus.

Less frequent infections included candida onychomycosis (5.9%) herpes simplex (3.2%), herpes zoster (1.8%), and dermatophytes (10.4%).

Of note, infection was significantly more common in patients with leukopenia, at 50% compared with 24% among patients without leukopenia. In fact, leukopenia was the only factor that was statistically significantly associated with dermatologic infection.

None of the demographic factors or treatments assessed were associated with the occurrence of a dermatologic infection.

Lacouture and co-authors comment that not all patients undergoing EGFRI therapy were cultured for dermatologic infection. “Therefore, it is likely that the study results underestimate the true incidence of dermatologic infection in cancer patients treated with EGFRIs,” they say.

“In addition to treating the characteristic dermatologic toxic effects, attention should be paid to preventing or treating complicating infections, with the goal of maintaining quality of life and dermatologic health, both of which are essential for the optimization of EGFRI therapies in cancer patients,” the researchers conclude in the Journal of the National Cancer Institute.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Laura Dean

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