25 research outputs found
Dermatosurgery in Dermatology
Glavne prednosti dermatokirurgije jesu njezina
jednostavnost i djelotvornost. Ipak, zahvati uÄinjeni bez prave
indikacije mogu rezultirati zaostajanjem ožiljaka i moguÄim
komplikacijama. Autorica opisuje niz dermatokirurŔkih tehnika
i postupaka kojima se koristimo za tretiranje dobroÄudnih i
malignih kožnih poremeÄaja. Ispravan odabir postupka ovisi o
diferencijalnoj dijagnozi, tipu i veliÄini zahvata. U radu se opisuju
i moguÄe komplikacije u dermatokirurÅ”koj praksi.The main quality of dermatosurgery lies in its
simplicity and effectiveness. Nevertheless, interventions without
adequate indication may result in unnecessary scaring and
various complications. A range of techniques for treating benign
and malignant skin disorders are described in the article. The
correct surgical procedure depends on the differential diagnosis,
and the type and extent of treatment. The author provides an
overview of basic dermatosurgical techniques and possible
complications in dermatosurgical practice
Kožne nuspojave u bolesnika na ciljanoj terapiji raka kolorektuma
Research in cancer development has led to the new treatment strategies based on gene and protein changes in cells that cause cancer. Such targeted drugs work differently than standard chemotherapy agents, and have different and usually less severe side effects. Targeted chemotherapies have, however, enormous cutaneous adverse events which may lead to poor adherence, dose interruption and discontinuation of these therapeutic regimens. Skin changes have a significant influence on the quality of life of affected patients. In colorectal cancer, several targeted drugs are currently employed. Agents administered in colorectal cancer that have resulted in significant cutaneous side effects include primarily the epidermal growth factor receptor inhibitors (EGFRIs) and capecitabine. Common EGFRIs dermatologic adverse events are acneiform rash and xerosis. Less common findings are paronychia, regulatory abnormalities of hair growth, maculopapular rash, mucositis and postinflammatory hyperpigmentation. Management of skin rash should be individualized for each patient, depending on the type, severity and location of the skin toxicity caused by EGFRIs. Hand-foot syndrome (HFS), or palmar-plantar erythrodysestesia, is the most common dose-limiting toxicity and the only clinically significant adverse event that frequently occurs with capecitabine compared to 5-FU/leucovorin intravenous administration. Cutaneous side effects affect compliance, patientsā quality of life, as well as the therapy regimen. It is important to recognize and treat, as well as to administer efficacious prophylactic and therapeutic measures in a timely manner. This enables regular administration of adequate chemotherapy regimens and prolongs lives of oncology patients. Studies have demonstrated a positive correlation between treatment efficacy and cutaneous side effects for both EGFRI and capecitabine. Therefore, cutaneous side effects can serve as a predictor of improved survival in these patients. Since frequency and severity of skin lesions are dose-dependent, a gradual increase in dose until a cutaneous side-effect develops might be a good strategy to maximize the efficacy of EGFRIs and capecitabine.Istraživanja nastanka zloÄudnih tumora dovela su do novih vrsta lijeÄenja koje se zasnivaju na promjenama gena i proteina u stanicama zloÄudnih tumora. Takvi ciljani lijekovi imaju drugaÄiji mehanizam djelovanja od standardnih citostatika, te obiÄno blaže nuspojave. Ciljani lijekovi meÄutim imaju znaÄajne nuspojave na koži koje mogu dovesti do slabije suradljivosti bolesnika, izostavljanja pojedinaÄne doze ali i prekida lijeÄenja. Promjene na koži znatno utjeÄu na kvalitetu života bolesnika. U lijeÄenju kolorektalnog karcinoma primjenjuje se nekoliko ciljanih lijekova. Od njih znaÄajne nuspojave na koži imaju inhibitori epidermalnog Äimbenika rasta (EGFRI), te kapecitabin. Äeste dermatoloÅ”ke nuspojave EGFRI su akneiformni osip i suhoÄa kože, dok su manje Äesti paronihija, poremeÄaji u rastu dlaka, makulopapulozni osip, mukozitis i postinflamatorne hiperpigmentacije. LijeÄenje nuspojava na koži treba biti prilagoÄeno svakom bolesniku, ovisno o vrsti, težini i mjestu nastanka promjena. Hand-foot syndrom (HFS, sindrom Å”aka i stopala) ili palmo-plantarna eritrodizestezija je najÄeÅ”Äa toksiÄnost koja ograniÄava doziranje lijeka i jedina kliniÄki znaÄajna nuspojava koja se Äesto javlja tijekom lijeÄenja kapecitabinom u usporedbi s intravenskom primjenom 5-FU/ leukovorina. Nuspojave na koži utjeÄu na suradljivost, kvalitetu života bolesnika te provoÄenje terapije. Važno je na vrijeme prepoznati, lijeÄiti te primijeniti uÄinkovite profilaktiÄke i terapijske mjere. Na taj naÄin se osigurava redovita primjena odgovarajuÄe terapije i produžava život onkoloÅ”kih bolesnika. KliniÄkim studijama je dokazana pozitivna povezanost uÄinkovitosti lijeÄenja onkoloÅ”kih bolesnika i nuspojava na koži kod uporabe EGFRI i kapecitabina. Stoga nuspojave na koži mogu poslužiti kao prediktor boljeg ishoda bolesnika. BuduÄi su uÄestalost i težina nuspojava na koži ovisne o dozi lijeka, postupno poviÅ”enje doze do pojave nuspojava na koži može biti dobar naÄin poveÄanja uÄinkovitosti kako EGFRi tako i kapecitabina
Adverse Reaction to Cetuximab, an Epidermal Growth Factor Receptor Inhibitor
No abstract availabl
The Most Common Cutaneous Side Effects of Epidermal Growth Factor Receptor Inhibitors and Their Management
The use of epidermal growth factor receptor inhibitors (EGFRI) for the treatment of solid tumors is increasing due to elevated expression of epidermal growth factor receptors (EGFR) in the stimulation of tumor development. EGFR inhibitors have shown to be effective in the treatment of neoplasms of the head, neck, colon, and lung. Inhibition of EGFR may cause cutaneous reactions in more than 50% of patients. The most common skin manifestations are papulopustular lesions in the seborrhoeic areas (upper torso, face, neck, and scalp). Other cutaneous side effects include xerosis and hair and nail changes. The onset of eruption is usually within one to three weeks after starting therapy, although in some cases it may occur much later. All dermatologic side effects are reversible and generally resolve after adequate therapy. However, for a minority of patients side effects are severe and intolerable, demanding dose reduction or even interruption of therapy. A positive correlation has been demonstrated between the degree of cutaneous toxicity and the antitumor response. For dermatologists the goal is to provide treatment of symptoms, so that the patient may continue to benefit from the EGFRI therapy. However, frequent cutaneous manifestations, even though related to a better antitumor response, may limit use of the therapy considering the interference with patient quality of life. Early management of cutaneous side effects of EGFRI may prevent severe, extensive symptoms, the need for dose reduction, or antitumor therapy interruption. This indicates a dermatologist should play a role in early stages of treatment.Ā </p