isotretinoin and nadifloxacin

In recent years inhibitors directed against the epidermal growth factor receptor (EGFR) have evolved as effective targeting cancer drugs. Characteristic papulopustular exanthemas, often described as acneiform rashes, are the most frequent adverse effect associated with this class of novel cancer drugs and develop in > 90% of patients. Notably, the rash may significantly compromise the patients' quality of life, thereby potentially leading to incompliance as well as dose reduction or even termination of the anti-EGFR therapy. Yet, an effective dermatologic management of cutaneous adverse effects can be achieved. Whereas various case reports, case series or expert opinions on the management of EGFR-inhibitor (EGFRI) induced rashes have been published, data on systematic management studies are sparse.. Here, we present a retrospective, uncontrolled, comparative study in 49 patients on three established regimens for the management of EGFRI-associated rashes.. Strikingly, patients' rash severity improved significantly over three weeks of treatment with topical mometason furoate cream, topical prednicarbate cream plus nadifloxacin cream, as well as topical prednicarbate cream plus nadifloxacin cream plus systemic isotretinoin.. In summary our results demonstrate that EGFRI-associated rashes can be effectively managed by specific dermatologic interventions. Whereas mild to moderate rashes should be treated with basic measures in combination with topical glucocorticosteroids or combined regiments using glucocorticosteroids and antiseptics/antibiotics, more severe or therapy-resistant rashes are likely to respond with the addition of systemic retinoids.

Topics: Administration, Topical; ErbB Receptors; Exanthema; Fluoroquinolones; Humans; Isotretinoin; Mometasone Furoate; Pregnadienediols; Protein Kinase Inhibitors; Quinolizines

The biological agent cetuximab specifically inhibits the epidermal growth factor receptor (EGFR) function. Cetuximab is licensed for treatment of metastatic colorectal carcinoma, as it enhances the efficacy of cytostatic therapy. Acneiform drug eruptions are common side effects. We report two patients with metastatic colorectal carcinoma, who developed a severe acneiform drug eruption on the face and upper part of the body during the treatment with cetuximab. Triple therapy consisting of systemic isotretinoin, topical nadifloxacin and topical corticosteroid produced rapid improvement with moderate cheilitis the only side effect. We conclude that triple therapy is an effective treatment for patients with severe acneiform drug eruptions caused by cetuximab.

Topics: Acneiform Eruptions; Administration, Oral; Administration, Topical; Adrenal Cortex Hormones; Anti-Bacterial Agents; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Cetuximab; Colorectal Neoplasms; Dermatologic Agents; Drug Eruptions; Drug Therapy, Combination; ErbB Receptors; Fluoroquinolones; Humans; Isotretinoin; Male; Middle Aged; Quinolizines; Treatment Outcome