Skin rash with cancer therapy

 

Initial assessment:

1. Is there associated fever or uncontrolled pain? ( grade 4)

If answer is yes to grade 4--> arrange admission--> draw baseline labs, CBC, blood /urine culture, CMP, start broad spectrum antibiotics covering staph and strep. Fluids, antiviral, antifungal etc Wound care.

If NO, assess if grade 3

2. Is the rash covering more than 30% of BSA, causing pain and limitation of self care ADL? ( grade 3): hold cancer treatment, treat pain, bleeding, any wounds. Check labs and vitals. Blood tests and cultures. Topical and systemic agents.

3. If grade 1 or 2, assess percentage: < 10% or 10-30%

maculopapular, pustular, acneiform

hyperkeratosis, moisture, erythema, tenderness, swelling, loss of sensation, open wounds

Drugs

Tyrosine Kinase Inhibitors (e.g.Gefitinib, Erlotinib, Afatanib and Lapatinib)

 mTOR Inhibitors (eg. Everolimus)

Dabrafenib

Cetuximab, panitumumab

BCCA symptom management