A number of different types of cutaneous reactions that affect the skin, hair, and nails can occur with cancer treatment. Oncology Nursing Society (ONS) Putting Evidence Into Practice (PEP) resources focus on those effects other than alopecia that are most often encountered, including rash, palmar-plantar erythrodysesthesia (PPE) (hand-foot syndrome), xerosis, paronychia, photosensitivity, and pruritus.
Cancer treatment-related skin reactions can have a significant negative effect on a patient’s physical functioning, well-being, and quality of life, and also may necessitate cancer treatment delays and limitations. The incidence of skin reactions varies according to the chemotherapeutic agents and treatment regimens used, but has been shown to increase in treatment with targeted therapies. Overall, incidence has been reported as follows: rash (as many as 100% of patients receiving targeted therapies), PPE (19%–82%, depending on the agent used), xerosis (3%–55%), pruritus (8%–52%), and paronychia (12%–16% of patients receiving epidermal growth factor receptor [EGFR] inhibitors). Those effects can be episodic, wax and wane, or spontaneously resolve. Sensitivity to sunlight, telangiectasias, and hyperpigmentation can be long-term or even permanent side effects of treatment.
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