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It has become important to be careful in terms of side effects with the increased lenalidomide use. The most commonly reported adverse events with the use of lenalidomide were hematologic toxicities and less frequently peripheral edema, infections, gastrointestinal disorders, fatigue, and muscle cramps. In particular, the nonserious rash is the most common cause of permanent discontinuation of lenalidomide. Although morbilliform, urticarial, or acneiform rashes have been observed with lenalidomide, malar rash-like lesions have not been described previously. Our aim is to present here 71-year-old female myelodysplastic syndrome patient with deletion of 5q abnormality who should be discontinued lenalidomide due to recurrent skin reaction like a malar rash.

Skin reactions have been reported with various antipsychotic drugs in scientific literature. It is important that clinicians be watchful of skin reactions in the elderly with antipsychotic medication, which can be an uncommon occurrence. It has been documented that the elderly are more prone to skin reactions with various forms of medication. We herewith report a case of skin reaction with risperidone in an elderly female patient.

Tissue adhesives are commonly used for skin closure in both surgical and nonsurgical specialties. Although they are very well tolerated, tissue adhesives can induce a localized allergic response in 0.5% to 14% of patients. Allergic response can result in wound dehiscence, patient discomfort, increased healing time, and suboptimal esthetic results. We present two cases of allergic reaction to anterior neck incisions following topical application of tissue adhesives. The patients were managed with local wound care, steroid administration, and one with subsequent revision surgery. Clinicians who routinely use tissue adhesives should understand the incidence, risk factors, and management of allergic reaction to these products. [ABSTRACT FROM AUTHOR]

Background: Anti‐programmed cell death 1 antibody is a standard therapy for advanced non‐small cell lung cancer (NSCLC). However, immune‐related adverse events (irAEs), such as skin reactions, are frequently observed. Although skin reactions are associated with clinical efficacy in melanoma, this association in advanced NSCLC and predictors of irAEs remain unclear. Accordingly, this study identified potential correlations of skin reactions with clinical efficacy and clinical predictors of development of skin reactions. Subjects, Materials, and Methods: We retrospectively surveyed patients with advanced NSCLC who received nivolumab or pembrolizumab monotherapy at Sendai Kousei Hospital (n = 155) during January 2016 to April 2018. Treatment efficacy was evaluated in patients with and without skin reactions, and associated predictive markers were determined. A 6‐week landmark analysis was conducted to assess the clinical benefit of early skin reactions. Results: Skin reactions were observed in 51 patients with a median time to onset of 6.4 weeks. The overall response rate (ORR) was significantly higher in patients with skin reactions (57% vs. 19%, p <.001). Median progression‐free survival (PFS) durations of 12.9 and 3.5 months and overall survival durations of not reached and 11.4 months were observed in patients with and without skin reactions, respectively. In the 6‐week landmark analysis, the ORR was significantly higher in patients with skin reactions, and skin reactions were significantly associated with increased PFS. A multivariate analysis identified pre‐existing rheumatoid factor (RF) as an independent predictor of skin reactions. Conclusion: Skin reactions appeared beneficial in patients treated with nivolumab/pembrolizumab for advanced NSCLC and could be predicted by pre‐existing RF. Further large‐scale validations studies are warranted. Implications for Practice: This single‐institutional medical record review that included 155 patients with advanced non‐small cell lung cancer who were treated with nivolumab or pembrolizumab monotherapy revealed that overall response rate and progression‐free survival were significantly better in patients with skin reactions. Pre‐existing rheumatoid factor was an independent predictor of skin reactions. Skin reactions are common immune‐related adverse events associated with PD‐1 therapy. This study investigated the association between the development of skin reactions and clinical benefit of skin reaction, as well as associated predictive markers, in patients with advanced non‐small cell lung cancer who were treated with nivolumab or pembrolizumab monotherapy. [ABSTRACT FROM AUTHOR]

Hand-foot syndrome (HFS) is a common skin toxicity of traditional chemotherapies. Some studies showed that HFS has an association with progression-free survival (PFS) and the overall survival (OS). So far, there is not available any systematic literature reviews or meta-analysis aimed to assess the associations between HFS, PFS and OS. For this reason, this study aims to quantitatively summarize, critically review, and interpret the recent literature related to the associations between HFS and efficacy of chemotherapy in terms of PFS and OS. Queries shaped by PICOM framework, a systematic search of three electronic databases (PubMed, Scopus, and Science Direct) was carried out for the period between January 2010 and December 2017. Quantitative data pooling was based on the calculation of Hazard Ratio (HR) with 95% Confidence Interval (95% CI) for the OS and PFS associated to the presence of HFS, through the data of original publications. Five papers were included in this systematic review for the quantitative data pooling. Patients with HFS showed improved PFS (HR = 0.532 [0.431-0.656]; p = 0.000) and improved OS (HR = 0.522 [0.427-0.638]; p = 0.000). HFS causes a reduction of compliance with oncology treatments. Healthcare providers should use this result as a trigger to foster patients' coping and the one of their family caregivers, enhancing their adherence to cancer treatments. [ABSTRACT FROM AUTHOR]

Introduction: With novel treatment strategies for acute myeloid leukemia becoming more readily utilized in the clinical practice setting, new data on potential treatment-related adverse events also has become available. Case report: We present a patient case on a previously unreported potential adverse event related to liposomal daunorubicin-cytarabine administration. The patient experienced bilateral discoloration of the palms of his hands that resolved after completion of the treatment cycle, only to recur at cycle two of therapy. Management and outcome: No intervention was required as the condition resolved within a week of onset. Discussion: With newer therapeutic modalities becoming more used in the clinical setting, it is important to understand the potential risks of treatment-related adverse events that come with them. To our knowledge this is the first case reporting blue-skin discoloration related to liposomal daunorubicin-cytarabine. [ABSTRACT FROM AUTHOR]

This case report presents an acute painful skin reaction several years after injection of site‐enhancing oils (SEO) induced by chemotherapy. This case exemplifies the long‐term dangerous side effects of the use of SEO, however treatable with prednisolone. [ABSTRACT FROM AUTHOR]

Background: Respiratory viruses like coronavirus disease (COVID-19) spread when mucus or droplets containing the virus get into your body through your eyes, nose or throat. Most often, this happens through your hands. Hands also are one among the foremost common ways in which the virus spreads from one person to subsequent. During a worldwide pandemic, one among the most cost-effective, easiest, and most vital ways to stop the spread of an epidemic is to scrub your hands frequently with soap and water1. But there may be mild to moderate skin reactions related to hand hygiene. Objective: To find out the consequences of repeated washing of hands to protect against coronavirus (COVID-19). Methods: 106 candidates were asked by questionnaire to fill 20 different questions related to time, duration, frequency and consequences of hand wash they are feeling. Result: The result of this study supports that 56% of people who are washing their hands at least 25-100 times a day are suffering from skin dryness. Conclusion: study suggests that repeated or frequent washing of hands can cause dryness and crack skin of hands even in individuals with no history of skin diseases [ABSTRACT FROM AUTHOR]

Aim: To determine whether acupressure can prevent or relieve the adverse drug reactions (ADRs) of anti‐tuberculosis drugs. Background: People receiving drug treatment for TB often experience ADRs that may cause them to stop taking their medication. Acupressure is a form of traditional Chinese medicine that can be applied to alleviate or prevent disease symptoms. Design: A double‐blinded, repeated‐measures clinical trial in hospitals in Taiwan was carried out from April 2015 – May 2017. Methods: Convenience sampling was used to select 32 people (15 for the experimental group and 17 for the control group) aged >20 years who were taking anti‐tuberculosis drugs. The people were randomized to receive 4‐week of true acupressure and 4‐weeks of sham acupressure. Acupressure therapy was given by a researcher in all cases. Both groups received treatment once per day on weekdays, with 15 min for each acupressure session. Outcomes (gastrointestinal irritation and adverse skin reactions) were assessed according to the people feedback and the physicians' recordings during the treatment course, and during monthly follow‐up visits for 6 months thereafter. Results: Both groups typically experienced gastrointestinal irritation and adverse skin reactions within 2 months of beginning anti‐tuberculosis drug treatment. The 4‐weeks intervention involving relevant acupressure points successfully relieved both types of side effects in both immediate and delayed manner. Conclusions: When correctly implemented, acupressure can prevent and relieve the ADRs of anti‐tuberculosis drugs, and motivate people to complete their treatment course. [ABSTRACT FROM AUTHOR]

Sorafenib has been established as one of the standard treatment for unresectable hepatocellular carcinoma, but the prognosis for this disease remains poor. Therefore, other treatment modalities such as local radiation therapywere widely investigated in many trials. As a result, the combination of Sorafenib and radiation therapy offered some promising results, but the distinct adverse effects of targeted therapeutics combined with radiation therapywere also observed. An undefined and rarely-reported skin reaction was observed in 2 elder patients with advanced hepatocellular carcinoma who underwent concurrent Sorafenib and radiation therapy.We describe this phenomenon as Sorafenib induced radiation in-field skin (SIRIS) reaction, and the clinical course and radiation dosimetry of these patients were reviewed. The development of SIRIS reaction was primarily limited within the radiation treatment fields, and it occurred at a relatively low dose during the courses of RT. The SIRIS reaction progressed in a radiation dose-dependent manner and was recovered spontaneously after 3-4 weeks of radiation therapy. The SIRIS reaction implicates a unique phenomenon that systemic skin reaction of targeted therapeutics, such as sorafenib, might be limited or exacerbated in specific regions by local radiation therapy. [ABSTRACT FROM AUTHOR]

Mosquito bite reactions consist of an immediate response characterized by an erythema and a wheal, which peaks at 20 min, and a delayed response characterized by a papule and/or an erythema, which peaks at 24 h. Mosquito bite reactions progress from stage I to stage V as an individual is repeatedly bitten as follows: stage I, neither immediate nor delayed reaction; stage II, delayed reaction; stage III, both immediate and delayed reaction; stage IV, immediate reaction; and stage V, neither immediate nor delayed reaction. In 1985, we conducted a cross‐sectional study that demonstrated a positive association between age and stage in response to an Aedes albopictus bite among 162 healthy volunteers. However, it remains unknown how the mosquito bite reaction stage progresses in the same individual over decades. In the present study, the mosquito bite reaction of 10 subjects from the 1985 cross‐sectional cohort was longitudinally evaluated over 30 years. We confirmed the time‐dependent progression of stage in four subjects. One stage II subject and three stage III subjects had advanced to the next stage. We went on to find that, contrasting with the general trend found in the previous studies, the majority of the subjects (6/10) remained of stage III over the 30‐year study period. Upon closer inspection, this apparently non‐progressive group demonstrated a reduction in the size of the delayed reactions. The present study demonstrated a marked individual variability in course of the stage progression. [ABSTRACT FROM AUTHOR]

Purpose: To assess skin dose and incidence of skin reactions in early breast cancer patients treated via Intrabeam™ intraoperative radiation therapy (IORT) device. Materials and methods: In total, 250 breast cancer patients treated with a single fraction of 20 Gy using 50 kV photon were recruited. The applicator to skin distance (ASD) was measured before the initiation of the radiation and the skin dose in each patient was accordingly calculated based on the treatment planning system (TPS). Results: The average skin doses calculated were equal to 7·91, 5·83, 3·96 and 2·14 Gy for 6–10, 10–15, 15–20 and 20–30 mm ASD values, respectively. It is noticeable that the skin doses could be lower than the TPS measurements up to 45%, mostly due to lack of backscatter radiation in breast tissue compared with the full scatter condition in the Zeiss water phantom. Finally, only three patients showed low-grade skin reactions 1 week after IORT. A review of the related literature also revealed the incidence of lower skin complications among patients treated via Intrabeam™ compared with MammoSite™ machine. Conclusions: The Intrabeam™ TPS did not seem to be very reliable for accurate skin dosimetry. However, breast cancer treatment using Intrabeam™ could result in fewer incidences of skin reactions than MammoSite™ machine. [ABSTRACT FROM AUTHOR]

Abstract Skin reaction or dermatological toxicities induced by immunotherapy is common. It usually manifests skin rash or erythema and can be cured by skin lotion or steroid. Nivolumab, a human IgG4 programmed cell death protein 1 (PD-1) inhibitor, blocks T cells activation preventing signal and allows the immune system to clear cancer cells. Nivolumab was approved in the second-line therapy in squamous cell lung cancer by FDA, with less than 10% unusual skin reaction, like sensory neuropathy, peeling skin, erythema multiforme, vitiligo, and psoriasis. Radiotherapy could aggravate this skin reaction through inflammatory response and promotion of immunity. The combined treatment of anti-PD-1 and radiotherapy represented a new promising therapeutic approach in many studies, but the risk of side effects may be high. We reported a patient with advanced squamous cell lung cancer who suffered from serious skin immune-related adverse events when he was treated with nivolumab and radiotherapy. The immune overreaction of the treatment of anti-PD-1 treatment and radiotherapy might cause these serious skin adverse events. Our report warranted careful workup to reduce the risk of side effects by combinative therapy with anti-PD-1 and radiotherapy. [ABSTRACT FROM AUTHOR]

purpose of this multicenter, prospective, observational, open-label study was to evaluate the use and tolerability of dermo-cosmetic products in preventing skin reactions associated with cancer treatments. Patients and methods: A 12-product kit was supplied to patients before chemotherapy began and was to be used throughout the treatment phase. Cutaneous adverse events were evaluated at each treatment session. Physicians evaluated skin reactions (edema, erythema, dryness, desquamation, pigmentation disorders, and cracks) and gave their opinion on the skin benefit for patients at the end of the study. Patients also evaluated the product benefit using the Patient Benefit Index (PBI) questionnaire. Results were analyzed by subgroups of casual and regular users, based on number and frequency of products used. Results: A total of 147 patients were enrolled in cancer services in Germany, France, Italy, Spain, and Canada. Mean age was 59 years with 71% being female. Product tolerance on whole body was rated good to excellent for at least 89% of the patients for each product. Aggravated skin reactions during the study were reported more frequently by casual users than regular users (39.5% versus 22%; p=0.029). Similarly, casual users reported more erythema aggravation (p=0.02) and desquamation (p=0.03) than regular users. PBI >1 was reported for 95.5% of patients and regular users had significantly higher scores than casual users (p=0.049). Discussion: Overall, the 12-product kit was very well tolerated, with regular users reporting benefits more frequently than casual users. Results support international recommendations to use appropriate skin care products to minimize the impact of cutaneous reactions associated with chemotherapy. [ABSTRACT FROM AUTHOR]

Bone anchored hearing aids (BAHA) are a useful support when conventional hearing aids are not suitable. The two types of attachment of the aid are onto a percutaneous abutment or a transcutaneous magnet. Anecdotally, the abutment requires more care, revision procedures and causes more infections than magnet-based devices. A multicentre, retrospective review was conducted of all patients that underwent a BAHA since our programme began, identified through a prospectively maintained database of patients. Patients' charts were audited for outpatient clinic visits, skin complications and revision surgeries. Developmental delay was also recorded. Patients were censored if the hearing aid was removed, replaced or the patient reached 16 years old. Bilateral or reimplanted patients were recorded as separate implants. Statistical analysis was performed using SAS version 9.4. 150 implants were assessed over 126 patients: 115 transcutaneous and 35 percutaneous. Percutaneous patients had significantly more outpatient clinic attendances (Least square mean 4.19 vs. 1.39 p = 0.00), skin complications (mean 4.82 v 0.11 p = 0.00) and theatre visits (mean 2.8 vs. 1.03 p = 0.00) compared to transcutaneous patients. 77 implants were in patients that had developmental delay; having same made no significant difference to above outcomes. There is a significant difference in healthcare burden between percutaneous and transcutaneous systems in a paediatric population. The increased cost of the percutaneous implant to the healthcare system and inconvenience to the patient is cause to consider a transcutaneous system in the first instance. • Bone anchored hearing aids are useful when conventional aids are not suitable as a first or second line in multiple medical and audiological conditions • We demonstrate that transcutaneous bone anchored hearing aids have a significantly lower rate of outpatient attendances, adverse skin events and theatre visits in a paediatric population • When considering the type of bone anchored hearing aid, we believe magnet-based aids should be considered more strongly in the paediatric setting from the outset systems due to significant skin-reaction-related complications around an abutment-based implant. [ABSTRACT FROM AUTHOR]

We investigated a skin adhesive closure device consisting of a self-adhesive polyester mesh placed over the surgical incision, followed by a liquid adhesive that is spread over the mesh and surrounding the skin. It is intended to reduce wound closure times, scarring, and skin complications associated with traditional closure with sutures or staples. The aim of this study was to report on skin reactions in patients who underwent primary total knee arthroplasty (TKA) using the skin adhesive closure system. A retrospective review of patients who underwent TKA using adhesive closure between 2016 to 2021 at a single institute was performed. A total of 1,719 cases were analyzed. Patient demographics were collected. The primary outcome was any postoperative skin reaction. Skin reactions were classified as allergic dermatitis, cellulitis, or other. Treatment(s), duration of symptoms, and surgical infections were also collected. A total of 5.0% (86) of patients were found to have any type of skin reaction following their TKA. Of these 86, 39 (2.3%) had symptoms of allergic dermatitis (AD), 23 (1.3%) had symptoms of cellulitis, and 24 (1.4%) had other symptoms. A total of 27 (69%) allergic dermatitis patients were treated with a topical corticosteroid cream only; their symptoms resolved within an average of 25 days. There was only 1 case of superficial infection (<0.001%). No prosthetic joint infections were observed. Despite skin reactions appearing in 5.0% of cases, the rate of infection was low. A patient-specific preoperative workup and effective treatment strategies can minimize complications associated with adhesive closure system and increase patient satisfaction following TKA. [ABSTRACT FROM AUTHOR]

Liraglutide is an antidiabetic drug given subcutaneously for weight reduction. We report a 35-year-old woman who presented with a rash after starting liraglutide. The rash consisted of erythematous well-defined plaques surrounded by ecchymotic patches on extensor aspects of the thighs at the sites of liraglutide injection with gradual onset and progressive course. The exact cause of the reaction is unknown. The eruption resolved after discontinuation of treatment.

Skin rashes have been reported after the start of various antipsychotic drugs in the scientific literature. It is important that psychiatrists be aware of antipsychotic-induced skin reactions in patients on antipsychotic medication which can be an uncommon yet possible occurrence. Patients with psychiatric problems may be prone to skin reactions and may not report the same as they may not be aware of the same. We herewith report a case of skin reaction with Olanzapine in a patient with schizophrenia.