Dermatologic adverse events (AEs) of cancer therapies can cause patient discomfort and impair their quality of life, increase the cost of medical care, and even result in dose modifications, all of which can negatively impact clinical outcomes.

The traditional cytotoxic chemotherapies are commonly associated with dermatologic AEs such as alopecia, hypersensitivity reactions, xerosis, skin hyperpigmentation, nail changes, and hand-foot syndrome (HFS).

Targeted therapies encompass drugs that inhibit selective molecules and pathways critical for carcinogenesis, tumor growth, and survival. The ensuing dermatologic AEs tend to vary depending on the entity targeted (e.g., epidermal growth factor receptor [EGFR], vascular endothelial growth factor/vascular endothelial growth factor receptor, immune checkpoints, mammalian target of rapamycin), although there is overlap.

Acneiform rash, xerosis, skin hyperpigmentation, alopecia, hair disorders (e.g. dyspigmentation, hypertrichosis, trichomegaly, textural changes), paronychia, and mucosal inflammation are characteristic dermatologic AEs of the EGFR inhibitors. Treatment with inhibitors of angiogenesis often leads to HFS, exanthems, hair disorders (alopecia, dyspigmentation, and textural changes), xerosis, mucositis, and in the case of bevacizumab/aflibercept, impairment of wound healing. The immune checkpoint inhibitors often result in pruritus and maculopapular cutaneous eruptions, although their AE profile, as with other newly developed drugs, is emerging and pending further characterization.

Timely recognition, prompt management of dermatologic AEs related to cancer treatment, and appropriate counseling are crucial for optimal clinical outcomes, and require a multidisciplinary approach involving oncologists, dermatologists, and nurses.