[Cutaneous lesions in COVID-19 patients]. / Huidafwijkingen bij covid-19.

Aside from the typical respiratory symptoms resulting from an infection with SARS-CoV-2, there are reports of cutaneous lesions in patients diagnosed with a SARS-CoV-2 infection. There are reports of multiple groups of skin lesions presenting in different stages of this diagnosis. The most common reported groups are chilblains, vesicular eruptions, morbilliformexanthems, acute urticaria and livedo. It is unlikely that all these groups of skin lesions are distinctive of an infection with SARS-CoV-2. Chilblains of new onset, however, could possibly be a distinctive symptom of a mild/asymptomatic infection with SARS-CoV-2. It is recommended to consider an infection with SARS-CoV-2 in the differential diagnosis in patients presenting with these groups of skin lesions. Consider testing for SARS-CoV-2 and consult the dermatologist if needed, especially in case of chilblains, to ensure histopathological evaluation of the skin lesions to increase knowledge of the underlying pathophysiology.

Classification and management of skin, hair, nail and mucosal side-effects of epidermal growth factor receptor (EGFR) inhibitors.

Inhibitors of epidermal growth factor receptor (EGFR) are commonly used as therapeutic agents in oncology. In contrast to currently used oncological treatments, these inhibitors almost always cause skin- and skin adnex toxicity. About 85% of treated patients develop to a more or lesser extent an acneiform eruption. Xerosis cutis and painful nail disorders occur in, respectively, 35% and 10-15% of all treated patients. Also hair and mucosal changes have been reported, although to a lesser extent. These skin- and skin adnex toxicities are reversible after withdrawal of treatment, but are seldom a reason to stop or interrupt therapy. This review outlines the classification, the pathogenesis and therapy of these skin, hair, nail and mucosal changes due to EGFR inhibition. Informing the patient and management of these side-effects is very important to reduce discomfort and as such to increase compliance to therapy.

[Long-term beneficial effects of cetuximab in a woman with metastasised rectal carcinoma without expression of the epidermal growth factor receptor]. / Langdurig gunstig klinisch effect van cetuximab bij een patiënte met een gemetastaseerd rectumcarcinoom zonder expressie van epidermale-groeifactorreceptor.

A 37-year-old woman presented with an epidermal growth factor-(EGFR)-negative rectum carcinoma with liver metastases. After extensive treatment, consisting of first-line chemotherapy, low anterior resection, isolated liver perfusion, second- and third-line chemotherapy and a pericardiodesis with bleomycin, she was subsequently treated with combination irinotecan and cetuximab therapy. At her last follow-up she had had long-term stable disease for 18 months with clinical benefit. Cetuximab is a monoclonal antibody which targets EGFRR. This exceptional case illustrates that treatment with cetuximab may be of benefit to a patient with EGFR-negative colorectal cancer. The exact mechanism of action and the role ofcetuximab in the treatment of advanced colorectal cancer have still to be determined.