Subject(s)
Blister/diagnostic imaging , Glucocorticoids/administration & dosage , Microscopy, Fluorescence/methods , Pemphigoid, Bullous , Biopsy, Needle/methods , Diagnosis, Differential , Extremities/pathology , Humans , Infant , Male , Pemphigoid, Bullous/diagnosis , Pemphigoid, Bullous/immunology , Pemphigoid, Bullous/physiopathology , Pemphigoid, Bullous/therapyABSTRACT
PURPOSE: Inhibition of the vascular endothelial growth factor receptor (VEGFR) with tyrosine kinase inhibitors (TKIs) is associated with cutaneous adverse effects that increase patient morbidity. Our objective was to examine the skin toxicity profile of anti-VEGFR TKIs and determine the changing incidence in clinical trials. METHODS: PubMed was queried for phase II or III trials of anti-VEGFR TKIs between 2000 and 2013 involving ≥50 patients. Adverse events were abstracted, with results presented in both fixed and random effects models. Odds ratios (OR) and 95 % confidence intervals (CIs) were estimated for studies with at least two arms. RESULTS: Across 82 included studies, all grades rash (OR, 2.68; 95 % CI, 2.45-2.94), hand-foot skin reaction (HFSR) (OR, 2.70; 95 % CI, 2.43-3.00), and pruritus (OR, 1.25; 95 % CI, 1.12-1.39) were associated with anti-VEGFR TKIs. Vandetanib had the highest incidence of rash (41 %), while sorafenib was most commonly associated with HFSR (37 %) and pruritus (14 %). The incidence of HFSR from 2000 to 2013 showed an upward trend (r (2) = 0.042, p = 0.10) and in sunitinib therapy increased significantly (r (2) = 0.237, p = 0.04). CONCLUSION: The incidence of HFSR, rash, and pruritus varies considerably by drug. Our data suggest a continued need to address skin toxicities and improve reporting strategies.
Subject(s)
Antineoplastic Agents/adverse effects , Protein Kinase Inhibitors/adverse effects , Receptors, Platelet-Derived Growth Factor/antagonists & inhibitors , Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors , Skin/pathology , Antineoplastic Agents/therapeutic use , Humans , Incidence , Indoles/adverse effects , Indoles/therapeutic use , Niacinamide/adverse effects , Niacinamide/analogs & derivatives , Niacinamide/therapeutic use , Phenylurea Compounds/adverse effects , Phenylurea Compounds/therapeutic use , Protein Kinase Inhibitors/therapeutic use , Pyrroles/adverse effects , Pyrroles/therapeutic use , Skin/drug effects , Sorafenib , Sunitinib , Vascular Endothelial Growth Factor A/metabolismABSTRACT
Angiolymphoid hyperplasia with eosinophilia is a rare, benign vascular lesion characterized by discrete, painful papules. Although the exact etiology is unknown, trauma precedes many cases. We present a case of angiolymphoid hyperplasia with eosinophilia in the earlobes of a 15-year-old girl after ear piercing.
Subject(s)
Angiolymphoid Hyperplasia with Eosinophilia/etiology , Angiolymphoid Hyperplasia with Eosinophilia/therapy , Body Piercing/adverse effects , Adolescent , Ear, External , Female , HumansABSTRACT
Basal cell carcinomas (BCCs) are the most common cancer in the United States, and the overwhelming majority of BCCs are the result of hedgehog pathway activation. While locally advanced and metastatic BCC are rare, currently available treatments remain limited and are often unsuccessful. Vismodegib inhibits a key regulatory protein in the hedgehog pathway and was approved by the United States Food and Drug Administration in 2012. This orally-administered medication offers a novel approach for treating locally advanced and metastatic BCC. The following review will address vismodegib's mechanism of action, published clinical trial data, and the questions that still remain unanswered about this new medication.
