Cutaneous reactions to chemotherapy

Patients undergoing cancer chemotherapy are often challenging to physicians from a management standpoint due to an unfortunate combination of general poor health, immunosuppression, and multi-drug regimens. Several chemotherapeutic agents are associated with well-described mucocutaneous toxicities. This chapter will address the commonly encountered adverse events associated with traditional chemotherapy medications such as chemotherapy- induced alopecia, mucositis, extravasation reactions, dyschromia, and acral erythema, among others. This will be followed by a discussion of the cutaneous toxicities associated with newer agents, namely, targeted therapies such as monoclonal antibodies and tyrosine kinase inhibitors. Finally, a brief discussion of radiation recall and enhancement is also included. By addressing important considerations in the recognition, diagnosis, and management of the cutaneous effects of cancer treatment, additional morbidity and potential mortality can be avoided in this already at-risk patient population.