Skin
Chemotherapy Related Damage
Alopecia:
- Alopecia is very common during therapy:
- Two principle patterns of alopecia
- 1. Anagen effluvium
- Chemotherapy treatment causes depressed mitotic activity resulting in weakened hair, or reduction in the overall number of hairs or no hair at all1
- Commonest
- Starts early in chemotherapy
- Generally resolves when chemotherapy stops (but occasionally hair growth never completely returns to normal
- 2. Telogen effluvium
- Hair loss several months after illness
- Related to stress
- Hair generally regrows
Nail changes:
- Chemotherapy may cause nail changes with diffuse, transverse or longitudinal bands of pigmentation and leuconychia1
- Therapy related causes of nail changes7:
- 5-FU
- Alkylating agents
- Taxanes
- Antimetabolites
- Anthracyclines
Oral ulceration:
- Ulceration of mucous membranes, especially of the mouth is common1
- Stomatitis is also common in children1
Extravasation:
Extravasation of certain chemotherapy drugs during IV treatment:
- May result in localized damage to the skin, with eventual necrosis and ulceration of the tissues1
- Left untreated can cause long term damage to the underlying tendons, nerves and vessels which would require surgical intervention1
Phototoxic Effects:
- Phototoxic effects result in reactions resembling sunburns in sun exposed regions
- Resolve within a few weeks1
- Caused by:
- Methotrexate
- Cyclophosphamide
Acral Erythema:
- Acute response to chemotherapy
- Uncomfortable burning sensation associated with swelling of the fingers and hands1
- The agents attributed to acral erythema:
- Cytarabine
- Pegylated liposomal doxorubicin
- Capecitabine
- 5-FU
Hyperpigmentation:
- Systemic hyperpigmentation can be caused by7:
- 5-FU
- Busulfan
- Usually resolves gradually after the end of therapy
- Localized hyperpigmentation during therapy associated with
- Thiotepa
- Ifosfamide
- Docetaxel
- Cisplatin
- Hydroxyurea
- Bleomycin
Steroid related skin changes:
- Systemic corticosteroid therapy may result in:
- Short term changes:
- Steroid induced acne
- Easy bruising and purpura
- Long-term changes:
- Straie distensae
- Cutaneous thinning of the skin
- Long term telangiectasia
