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Skin Changes Caused By Targeted Chemotherapies

Can skin changes be treated?

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© American Cancer Society 2010

Mild changes

Patients with mild skin changes may not need any treatment. These changes include rashes that are only in a limited area, not causing any distress, and not infected. The doctor may prescribe a mild corticosteroid cream (such as hydrocortisone) or antibiotic gel (such as clindamycin) to apply to the area.

The dose of the targeted therapy drug is usually not changed, and the patient is closely watched to see if the rash gets better or worse.

Moderate changes

These include a rash over a larger area of the body or skin changes causing mild distress from itching or soreness, but with no signs of infection. Skin treatment may be hydrocortisone cream, clindamycin gel, or pimecrolimus (Elidel ) cream. The doctor may also prescribe an antibiotic such as doxycycline or minocycline to be taken by mouth.

The dose of the targeted therapy drug is usually not changed, and the patient is closely watched to see if the rash gets better.

Severe changes

These are bad rashes that cover a lot of skin, cause itching and soreness that affect the patient's quality of life (such as sleep problems or pain), and are likely to get infected. Treatment is much like that used for moderate changes, including a topical cream or gel (hydrocortisone cream, clindamycin gel, or pimecrolimus cream), as well as an antibiotic such as doxycycline or minocycline that is taken by mouth. Along with this, a course of an oral corticosteroid, such as methylprednisolone (Medrol ) or prednisone, is often given.

The targeted therapy drug dose is often reduced for these skin changes. If the rash does not get better in 2 weeks, the targeted drug is often stopped until the skin changes improve. It may then be re-started with ongoing skin care.

A note about steroid skin creams and gels

Topical steroids (those that are spread on the skin in the form or creams, ointments, or gels) can be helpful for many skin problems. They can be used for up to 7 days after the problem has gone away. But it is important to know that long-term use of steroid creams can cause skin problems, and can make you more likely to get a skin infection. For this reason, steroid creams should not be used more than 14 days in a row. Many doctors suggest that patients who are given steroids to put on their skin use it in a cycle. For instance, you might use it every day for 14 days, and then stop using it for a 7 day break. This cycle can be repeated as long as you have skin problems, or until your doctor tells you to stop.

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