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Open Access Maced J Med Sci 2019 Mar 27;7(6):973-977. Epub 2019 Mar 27.

Section of Dermatology, University of Naples Federico II, Naples, Italy via Sergio Pansini 5, 80131 Naples, Italy.

Background: Tyrosine kinase inhibitors (TKIs) have been introduced for the treatment of lung cancer, improving progression-free survival, objective response rate, and quality of life. However, TKIs can lead to cutaneous toxicities, including papulopustular rash, xerosis, paronychia with/without pyogenic granulomas, scalp disorders, facial hair and/or eyelash growth.

Aim: In this study, we describe retrospectively all cases of mucocutaneous side effects in patients with lung cancer under TKIs referring to our outpatient for the skin care of oncological patients. Read More

Tech Hand Up Extrem Surg 2019 Apr 9. Epub 2019 Apr 9.

Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore.

Septic arthritis of the small joints of the hand usually occurs secondary to bacterial inoculation through penetrating injury to the joint, or direct spread of infection from paronychia, felon, or pyogenic flexor tenosynovitis. Surgical treatment involves drainage and irrigation and may involve debridement if there is an open wound. We describe a method of continuous irrigation of septic joints of the hand postoperatively in the ward setting using an intravenous cannula placed within the joint and connected to an intravenous giving set with delivery of physiological fluid using a pump driver. Read More

J Eur Acad Dermatol Venereol 2019 Apr 1. Epub 2019 Apr 1.

Hôpitaux universitaires Saint Pierre & Brugmann, Hôpital universitaire des enfants Reine-Fabiola, Université Libre de Bruxelles, Belgium.

The term retronychia originated in 1999 (1) and a first series of cases was published in 2008. (2) A disturbance in the continuous longitudinal nail growth (3) leads to an upward and backward nail displacement with posterior embedding. Several nail plates pile up beneath the proximal nail fold (PNF) generating paronychia and granulation tissue. Read More

J Cutan Med Surg 2019 Mar 27:1203475419839937. Epub 2019 Mar 27.

1 Cutaneous Lymphoma Program, Department of Dermatology, University of Pittsburgh Medical Center, PA, USA.

Background:: The onychodystrophies associated with Sézary syndrome (SzS) have rarely been described in the literature. We performed a retrospective analysis of SzS patients at a single institution and compared our data with previous publications.

Objectives:: The objectives of this study were to identify and describe the most frequent nail alterations in patients with SzS. Read More

J Dermatolog Treat 2019 Mar 20:1-5. Epub 2019 Mar 20.

a Section of Dermatology , University of Naples Federico II, Naples , Italy. via Sergio Pansini 5 , 80131 Naples , Italy.

The term retronychia describes the proximal ingrowth of the nail that occurs when the nail plate (NP) embeds backwards into the proximal nail fold (PNF). Proximal avulsion of the nail remains the treatment of choice however, permanent postsurgical nail dystrophy can occur. We report here a case series of retronychia treated through chemical avulsion with 50% urea and 10% salicylic acid in vaseline white petroleum, covered by occlusive dressing and kept for 1 week. Read More

J Clin Aesthet Dermatol 2019 Jan 1;12(1):35-37. Epub 2019 Jan 1.

Dr. Sompson is with the Oregon MedicoI Group in Eugene/Springfield, Oregon (with the Deportment of Dermatology at University of Utah in Salt Lake City, Utah (at the time of this work).

We present a case of medication-associated paronychia involving multiple toenails in a patient undergoing hepatitis C (HCV) therapy with ledipasvir/sofosbuvir. The patient was treated conservatively with topical mupirocin, clobetasol ointment, and acetic acid soaks, resulting in symptom improvement and control. This topical regimen was maintainined throughout the remaining weeks of the patient's antiviral course, with complete symptom resolution occurring only after completion of his ledipasvir/sofosbuvir treatment. Read More

Med Princ Pract 2019 Mar 12. Epub 2019 Mar 12.

Objective: A 57-year-old female with a 33-year history of constant hand discoloration and paronychia had undergone multiple evaluations with a failure to find a diagnosis. She continues to undergo an evolving treatment regimen and diagnostic workup in an effort to find a long-eluded diagnosis.

Clinical Presentation: She began to develop superficial ulcerations over the proximal phalanx of her fingers, often pruritic and erythematous, with pain and edema. Read More

Support Care Cancer 2019 Mar 7. Epub 2019 Mar 7.

Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples "Federico II", Naples, Italy.

Paronychia and periungual pyogenic granuloma represent one of the most common and bothersome dermatologic toxicities observed with ErbB inhibitors. There is no standardized treatment, and management remains challenging. Moreover, conservative management with noninvasive treatment should be promoted for fragile patients in a metastatic setting. Read More

J Oncol Pharm Pract 2019 Mar 4:1078155219833441. Epub 2019 Mar 4.

1 Rx To Go, Florida Cancer Specialists, Fort Myers, FL, USA.

Purpose: To describe the outcomes of a pharmacist-led multi-center, collaborative patient education and proactive adverse event management program in a community-based oncology setting.

Methods: Patients with EGFR mutation-positive ( EGFRm+) non-small cell lung cancer, newly prescribed with oral afatinib, and monitored as part of the Florida Cancer Specialists patient management program, were included in a retrospective, observational analysis. During follow-up, data were collected on adverse event frequency, and changes in afatinib dosing. Read More

Indian J Dermatol Venereol Leprol 2019 Feb 26. Epub 2019 Feb 26.

Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India.

Zhongguo Fei Ai Za Zhi 2019 Feb;22(2):57-81

Department of Oncology, Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200030, China.

ErbB receptor tyrosine kinase inhibitors (EGFR-TKI), gefitinib, erlotinib, icotinib and aftinib, which are approved as a frontline treatment for patients with non-small cell lung cancer (NSCLC) who have tumors harboring EGFR mutations in China. And osimertinib was approved in second line setting for patients with EGFRT 790M-positive NSCLC. Rash, paronychia, diarrhea, stomatitis, liver dysfunction and (interstitial lung disease, ILD) are frequently observed in patients treated with EGFR-TKI. Read More

Am Fam Physician 2019 Feb;99(4):228-236

U.S. Marine Corps School of Infantry-East, Camp Geiger, NC, USA.

Acute hand infections are often caused by puncture wounds and are generally classified into superficial or deep infections. Superficial infections occur in the skin and subcutaneous tissues, whereas deep infections can involve the tendon sheaths, adjacent anatomic compartments, deep fascial planes, bursae, joint spaces, and bones. Superficial hand infections are more common than deep infections and are typically managed with elevation, warm soaks, splinting in the position of function, analgesics, and empiric antibiotics when indicated. Read More

BMC Dermatol 2019 01 23;19(1). Epub 2019 Jan 23.

Dermatology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Background: Mucous membrane pemphigoid (MMP) is an autoimmune blistering disease that is notoriously difficult to treat. Nail involvement in MMP is rare.

Case Presentation: We report on a 58 years old man with severe MMP who presented with onychomadesis. Read More

Skin Appendage Disord 2018 Nov 30;5(1):32-37. Epub 2018 May 30.

Department of Dermatology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Introduction: Chronic paronychia (CP) is an inflammatory disease of the nail folds. Staging of CP is important for clinicians. We developed an objective scale that evaluates each finding of CP separately in addition to evaluating the treatment process and follow-up. Read More

Front Oncol 2018 13;8:616. Epub 2018 Dec 13.

Department of Pharmacy, National Cancer Center Hospital East, Kashiwa, Japan.

Skin toxicity is a common adverse event during cetuximab (Cmab) treatment. However, few reports have investigated the correlation between skin toxicity and the efficacy of Cmab in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). We retrospectively reviewed 112 R/M SCCHN patients who received palliative chemotherapy with Cmab. Read More

Onco Targets Ther 2018 12;11:9033-9047. Epub 2018 Dec 12.

Department of Pharmacy, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, People's Republic of China,

Background: Osimertinib is an EGFR-TKI that is selective for both EGFR-TKI-sensitizing and T790M resistance mutations in patients with non-small-cell lung cancer (NSCLC). The purpose of this study was conducting a meta-analysis to evaluate the clinical efficacy and safety of osimertinib in the treatment for NSCLC.

Methods: Using "osimertinib" as a keyword combined with "non-small-cell lung cancer" and "randomized controlled trial" as medical subject headings, the following electronic databases were searched: PubMed, EMBASE, Cochrane Library, and China National Knowledge Infrastructure. Read More

Curr Oncol 2018 10 31;25(5):e385-e390. Epub 2018 Oct 31.

Princess Margaret Cancer Centre, University Health Network, Toronto, ON.

Background: Afatinib, an irreversible epidermal growth factor receptor tyrosine kinase inhibitor (egfr tki), is approved for first-line therapy in advanced mutation-positive non-small-cell lung cancer (nsclc) and has previously demonstrated activity after failure of chemotherapy and reversible egfr tkis, with improved response and progression-free survival, compared with placebo. Outcomes in pretreated patients with advanced nsclc receiving afatinib through a Canadian special access program (sap) are reported here.

Methods: Patients with nsclc progressing after at least 1 line of chemotherapy and an egfr tki were eligible to enrol in the sap. Read More

Am J Clin Dermatol 2018 Nov;19(Suppl 1):31-39

Institut Universitaire du Cancer Toulouse - Oncopole, 1 avenue Irène Joliot-Curie, 31059, TOULOUSE Cedex 9, France.

Targeted therapies and immunotherapies are associated with a wide range of dermatologic adverse events (dAEs) resulting from common signaling pathways involved in malignant behavior and normal homeostatic functions of the epidermis and dermis. Dermatologic toxicities include damage to the skin, oral mucosa, hair, and nails. Acneiform rash is the most common dAE, observed in 25-85% of patients treated by epidermal growth factor receptor and mitogen-activated protein kinase kinase inhibitors. Read More

Cancer Chemother Pharmacol 2018 Dec 22;82(6):979-986. Epub 2018 Oct 22.

Institut Universitaire du Cancer de Toulouse, Oncopôle, 1 avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France.

Background: Trastuzumab is the mainstay of therapy for patients with HER2-positive breast and gastric cancer but resistance frequently occurs. Afatinib, an irreversible oral ErbB family blocker, shows clinical activity in trastuzumab-refractory HER2-positive metastatic breast cancer.

Materials And Methods: This phase I study used a modified 3 + 3 dose escalation design to determine the maximum tolerated dose (MTD) of oral once-daily afatinib in combination with 3-weekly intravenous trastuzumab (8 mg/kg week 1; 6 mg/kg 3-weekly thereafter) for patients with confirmed advanced or metastatic HER2-positive cancer. Read More

J Dermatolog Treat 2018 Nov 28:1-2. Epub 2018 Nov 28.

a Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA.

Neratinib is a tyrosine kinase inhibitor that was FDA-approved for extended adjuvant treatment in adults with human epidermal growth factor receptors-2 (HER-2) positive breast cancer in 2017. Due to the novelty of the drug, there are no current reports in the literature of adverse cutaneous effects associated with neratinib therapy. We present a case of a woman on neratinib for HER-2 positive infiltrating ductal carcinoma of the right breast who presented to the dermatology clinic with changes to the fingernails, acne, and a rash on the face. Read More

Br J Dermatol 2019 Mar 29;180(3):676-677. Epub 2018 Nov 29.

Section of Dermatology, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.

Eur J Intern Med 2019 04 5;62:e5-e6. Epub 2018 Oct 5.

Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. Electronic address:

Indian Dermatol Online J 2018 Sep-Oct;9(5):314-317

Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Background: Nail involvement in psoriasis is often complicated by concomitant fungal infections. The aim of this study was to investigate the prevalence of fungal infections in nail psoriasis and correlate it with the severity of nail psoriasis.

Materials And Methods: This retrospective study included patients with nail psoriasis aged ≥18 years with at least one fingernail and one toenail involvement who were treated at Siriraj Hospital from September 2012 to January 2014. Read More

Indian Dermatol Online J 2018 Sep-Oct;9(5):293-298

Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany.

Paronychia is a painful inflammatory disorder of the nail fold. Periungual pyogenic granuloma - a benign vascular tumor of the capillaries - can develop as a complication of paronychia. We report both, paronychia and periungual pyogenic granuloma, as possible adverse events during systemic drug-therapy. Read More

Anticancer Res 2018 Sep;38(9):5231-5237

Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.

Background/aim: The aim of this study was to evaluate the safety and efficacy of osimertinib for elderly patients, since the data remain limited.

Patients And Methods: A total of 77 patients with advanced non-small cell lung cancer (NSCLC) harboring the epidermal growth factor receptor (EGFR) T790M mutation and treated with osimertinib were reviewed. Efficacy and safety indicators, such as EGFR-tyrosine kinase inhibitor (TKI)-related adverse events (AEs) and osimertinib-associated hematotoxicity, were evaluated in elderly patients (elderly group, EG; age, ≥75 years) by comparing them with younger patients (non-EG; aged <75 years). Read More

Cancer 2018 Oct 7;124(19):3830-3838. Epub 2018 Sep 7.

Department of Medical Oncology, Takarazuka City Hospital, Takarazuka, Japan.

Background: Preclinical studies suggested that the addition of bevacizumab could overcome acquired resistance (AR) to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). The aim of this study was to evaluate the clinical efficacy and safety of a combination of afatinib and bevacizumab after AR.

Methods: Patients with EGFR-mutant non-small cell lung cancer after AR were enrolled during any line of therapy. Read More

An Bras Dermatol 2018 Sep-Oct;93(5):707-711

Dermatology Department, Hospital do Servidor Público Municipal de São Paulo, São Paulo (SP), Brazil.

Retronychia is a recently described disorder caused by ingrowth of the proximal nail plate into the proximal nail fold. It is suspected when there is persistent paronychia, particularly in the setting of trauma. This disease is probably underdiagnosed due to limited knowledge among dermatologists and the presence of incomplete clinical forms. Read More

Front Med (Lausanne) 2018 14;5:227. Epub 2018 Aug 14.

Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland.

Pemphigus vulgaris lesions have a tendency to localize around natural body orifices. The aim here was to analyze the involvement of nail apparatus in pemphigus vulgaris. Sixty seven ethnic Poles suffering from pemphigus vulgaris on photographic files archiving initial presentation were retrospectively evaluated. Read More

J Dermatol 2018 Nov 25;45(11):1362-1366. Epub 2018 Aug 25.

Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.

We describe a case of a 23-year-old female patient with no apparent underlying diseases. She showed a discoloration of the proximal portion of the left big toenail with paronychia. Direct microscopy revealed septate hyphae with conidiophores, and a periodic acid-Schiff-stained nail specimen revealed septate hyphae branching at angles of approximately 45°. Read More

Asian Pac J Cancer Prev 2018 Aug 24;19(8):2325-2330. Epub 2018 Aug 24.

Department of Pharmacy, National Hospital Organization Hokkaido Cancer Center, Japan. Email:

Background: Cetuximab-induced skin disorder is common in colorectal cancer (CRC), and is known to affect prolonged overall survival (OS). Patients with left-sided CRC survive longer than those with right-sided CRC, among those treated with combination cetuximab and chemotherapy. However, no study has evaluated patient prognosis in terms of OS and progression-free survival (PFS) in relation to both tumor location and skin disorder. Read More

Support Care Cancer 2019 Mar 16;27(3):1029-1039. Epub 2018 Aug 16.

Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada.

Purpose: Afatinib is a standard first-line therapy for advanced EGFR-positive NSCLC. We implemented a pharmacist-led proactive follow-up algorithm to identify and manage early afatinib-related adverse events (AEs).

Methods: We conducted a retrospective chart review of all patients treated with afatinib after implementation of the algorithm at the Sunnybrook Odette Cancer Centre (Toronto, ON, Canada) from April 1, 2015 to July 31, 2016. Read More

Mol Clin Oncol 2018 Aug 30;9(2):201-206. Epub 2018 May 30.

Department of Pharmacy, Ogaki Municipal Hospital, Ogaki-shi, Gifu 503-8502, Japan.

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), including gefitinib, erlotinib and afatinib are standard first-line treatments for EGFR gene mutation-positive non-small cell lung cancer. The present study aimed to compare the cost-effectiveness of using erlotinib, afatinib or gefitinib. The safety of EGFR-TKIs was also investigated. Read More

J Am Acad Dermatol 2018 Aug 3. Epub 2018 Aug 3.

Senior Consultant Dermatologist, KIMS AL SHIFA Super Speciality Hospital, Perinthalmanna, Kerala, 679 322. India. Electronic address:

Cutis 2018 Jun;101(6):466-468

Bay Pines VA Healthcare System, St. Petersburg, Florida, USA.

Imiquimod is a topical immunomodulating medication approved by the US Food and Drug Administration for the treatment of condyloma acuminata, actinic keratoses (AKs), and superficial basal cell carcinoma (BCC). Imiquimod commonly is used off label for its antiviral and antitumoral effects. We present a case of a 51-year-old man with vitiligolike depigmentation following treatment of periungual verruca vulgaris with imiquimod therapy. Read More

J Oncol Pharm Pract 2018 Jul 25:1078155218788707. Epub 2018 Jul 25.

3 Division of Hematology and Cellular Therapy, Allegheny Health Network, Pittsburgh, USA.

Background Ibrutinib, a Bruton's tyrosine kinase inhibitor has reformed the treatment of various B-cell malignancies including chronic lymphocytic leukemia, mantle cell lymphoma, and Waldenstrom's macroglobulinemia. Although generally well tolerated, here we describe our institutional experience of unique adverse effects encountered with the use of ibrutinib in patients with B-cell lymphomas. Methods This is a retrospective observational study done at a tertiary care facility, to evaluate adverse events in patients with B-cell malignancies on treatment with ibrutinib between 2014 and 2018. Read More

Drug Des Devel Ther 2018 11;12:2163-2167. Epub 2018 Jul 11.

Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, The People's Republic of China,

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are a strain of small molecule inhibitors mainly used to treat the metastatic non-small cell lung cancer. Their predominant adverse effect is skin toxicity, usually manifested as acneiform rash, skin fissure, xerosis, and paronychia. Severe epidermal necrosis and exfoliation rarely occur. Read More

J Hand Surg Am 2019 Jan 14;44(1):46-54. Epub 2018 Jul 14.

Department of Orthopedic Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX. Electronic address:

Infections are common in hand surgery and proper management is important to achieve optimal outcomes. Although most cases are not urgent, less common, severe infections such as flexor tenosynovitis and necrotizing fasciitis require urgent identification with both medical and surgical management. It is common for diagnoses to be missed or delayed because clinical and laboratory indicators are often variably present. Read More

Cancer Chemother Pharmacol 2018 Sep 20;82(3):407-418. Epub 2018 Jun 20.

Cancer Medicine Division, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.

Purpose: The phase I study characterized the safety, pharmacokinetics, anti-tumor activity, and recommended phase II dose/schedule of LY3164530 in patients with advanced or metastatic cancer.

Methods: Patients received LY3164530 on days 1 and 15 (Schedule 1: 300, 600, 1000, and 1250 mg) or Days 1, 8, 15, and 22 (Schedule 2: 500 and 600 mg) of each 28 days cycle. Dose escalation used a modified toxicity probability interval model. Read More

Oncology 2018 14;95(4):251-256. Epub 2018 Jun 14.

Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan.

Purpose: The purpose of the study was to evaluate the site of paronychia in patients with non-small cell lung cancer harboring an epidermal growth factor receptor (EGFR) gene activating mutation who were treated with EGFR tyrosine kinase inhibitors (EGFR TKIs).

Patients And Methods: The study included 55 patients with non-small-cell lung cancer who were treated with an EGFR TKIs. Resulting all toxicities were graded using the Common Terminology Criteria for Adverse Events version 4. Read More

Cancer Res Treat 2019 Apr 13;51(2):502-509. Epub 2018 Jun 13.

Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Purpose: We tried to evaluate whether there are any specific features in treatment outcomes of firstline afatinib in patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC), compared with gefitinib or erlotinib.

Materials And Methods: We analyzed patients treated with first-line afatinib, gefitinib, or erlotinib for advanced EGFR-mutant NSCLC at Samsung Medical Center between 2014 and 2016.

Results: In total, 467 patients received first-line afatinib (n=165), gefitinib (n=230), or erlotinib (n=72). Read More

J Eur Acad Dermatol Venereol 2019 Jan 6;33(1):204-212. Epub 2018 Jul 6.

Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Background: Oncologic treatments may lead to the development of paronychia, which may cause severe pain and disability. However, a detailed objective scoring system is lacking.

Objective: To develop an objective scoring system to quantify the severity of paronychia and also examine the correlation of this score with a pain index and patients' quality of life. Read More

Am J Clin Dermatol 2018 Oct;19(5):671-677

Department of Dermatology, University of California San Diego, 10991 Twinleaf Court, La Jolla, San Diego, CA, 92131-3642, USA.

Coagulase-negative staphylococcus organisms may be normal flora of human skin, however these bacteria can also be pathogens in skin and soft tissue infections. A summary of skin and soft tissue infections caused by coagulase-negative staphylococcus species is provided in this review. We conducted a search of the PubMed database using the following terms: abscess, auricularis, biofilm, capitis, cellulitis, coagulase, contaminant, cyst, draining, epidermidis, felon, folliculitis, furuncle, haemolyticus, hominis, indolent, infection, lugdunensis, mecA, microbiome, negative, osteomyelitis, paronychia, saprophyticus, skin, simulans, sinus, soft, staphylococcus, systemic, tissue, virulence, virulent, and vulvar. Read More

J Pediatr Hematol Oncol 2019 Mar;41(2):e108-e110

Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Sapporo, Japan.

Background: At our institution, we noted that children with hematologic malignancies and solid tumors often suffered from ingrown toenails (IGTNs) during hospitalization for chemotherapy and stem cell transplantation. However, only few reports have dealt with IGTNs in the above setting.

Procedure: Between August 2007 and July 2017, 180 children who received treatment for hematologic malignancies and solid tumors at our institute were enrolled in this study. Read More

Future Oncol 2018 Oct 4;14(24):2531-2541. Epub 2018 May 4.

Department of Medical/Clinical Oncology, Christie Hospital, 550 Wilmslow Road, Manchester, UK.

Cutaneous toxicities associated with EGFR inhibitors (EGFRIs) have a significant impact on patient treatment continuation, quality of life and healthcare resource utilization. This paper reviews the current prophylaxis and management of EGFRI-induced cutaneous toxicities in patients with colorectal cancer, and combines these findings with the authors' clinical expertise to define a novel algorithm for healthcare professionals managing patients receiving EGFRIs. This tool includes a grading system based on the location, severity and psychological impact, and provides a standard prescription pack, advice on prophylaxis/self-management of cutaneous symptoms for patients initiating EGFRIs, and essential guidance on subsequent review and treatment escalation. Read More

Case Rep Dermatol Med 2018 30;2018:3230582. Epub 2018 Jan 30.

Department of Dermatology, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.

Onychophagia, which refers to compulsive nail-biting behavior, is common among children and young adults. Onychophagia can cause destruction to the cuticle and nail plate, leading to shortening of nails, chronic paronychia, and secondary infections. Relatively uncommon effects include pigmentary changes, such as longitudinal melanonychia and splinter hemorrhages. Read More

Oncologist 2018 Aug 12;23(8):891-899. Epub 2018 Apr 12.

Memorial Sloan Kettering Cancer Center, New York City, New York, USA

Dermatologic adverse events (dAEs) are common with the use of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy. First- and second-generation agents (erlotinib, gefitinib, and afatinib) are frequently associated with acneiform rash, pruritus, xerosis, and paronychia; the incidence and characterization of these dAEs have been well described. However, there is evidence that the dAE profile is different with third-generation EGFR-TKIs. Read More

J Drugs Dermatol 2018 Apr;17(4):475-478

Proximal subungual onychomycosis (PSO), which predominantly involves the nail plate from the proximal nail fold, is the rarest form of onychomycosis. Classically associated with an immunocompromised state, PSO is an uncommon diagnosis in individuals without immunodeficiency. We present a case of a healthy 51-year-old man, who presented with a three-month history of white discoloration of multiple toenails. Read More

Rom J Intern Med 2018 Sep;56(3):173-181

Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Indonesia, Persahabatan National Respiratory Referral Hospital, Jalan Persahabatan Raya No. 1, Rawamangun,Jakarta, Indonesia.

Introduction: Combinations of gefitinib and radiotherapy have been observed to have synergistic and anti-proliferative effects on lung cancer in vitro. In the clinical setting, patients who presented with respiratory difficulties such as superior vena cava syndrome (SVCS), radiotherapy should be given immediately to address the emergency while waiting for the results of epidermal growth factor receptor (EGFR) mutation test. However, there has been no study that described the role of radio-therapy in Indonesian patients with EGFR-mutant lung adenocarcinoma. Read More

Case Rep Med 2018 11;2018:5980937. Epub 2018 Jan 11.

Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Pemphigus vegetans is a rare variant of deep acantholytic pemphigus which usually presents with vesiculobullous rash and vegetative plaques on the folds. We report a case of pemphigus vegetans patient who presented with rashes on tips of fingers and toes resembling paronychia and onychomadesis that misled the diagnosis for months. The final diagnosis of Hallopeau-type pemphigus vegetans was made based on histopathology and direct immunofluorescence studies. Read More

Respir Investig 2018 Mar 21;56(2):179-183. Epub 2017 Dec 21.

Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi Ward, Hamamatsu, Shizuoka 431-3192, Japan. Electronic address:

Background: The management of skin toxicity is crucial for efficient afatinib treatment, but the role of tetracycline class antibiotics (TCs) in managing these rashes is relatively unknown.

Methods: We reviewed the clinical records of patients who were administered afatinib for the treatment of non-small cell lung cancer harboring epidermal growth factor receptor mutations between October 2014 and November 2016. Twenty-five patients, who received TCs for the management of afatinib-related skin disorders, were enrolled. Read More