Oncologic Therapies and Cutaneous Toxicity



Cancer is a disease fundamentally caused by genetic alterations that lead to uncontrolled cellular proliferation. Consequently, chemotherapeutic and/or biological agents aim to eliminate the malignant cells by interfering with essential cellular processes, particularly at the level of the skin.

Commonly used Chemotherapeutic and Biological Agents

Conventional chemotherapeutic agents can be classified into three main categories: Antimetabolites, which interfere with DNA and RNA synthesis; Mutagenic agents, which directly damage DNA; Antimitotic agents, which inhibit cell division.

A more recent and targeted approach is immunotherapy. Targeted therapy refers to the use of drugs that block specific molecular targets, thereby inhibiting the growth and spread of cancer cells.

Cutaneous Toxicity induced by Oncologic Treatments

Many anticancer drugs are associated with cutaneous toxicity as a side effect, with onset times that may vary significantly among individuals.

The primary underlying cause is the high density of lymphocytes in the skin and the rapid turnover of epithelial cells. Activated lymphocytes may target not only malignant cells but also healthy tissues. In the case of monoclonal antibodies, the severity of cutaneous lesions appears to be directly correlated with the therapeutic efficacy of the drug.

The most common dermatologic adverse effects include skin rash, pruritus, vitiligo, and xerosis, with more severe manifestations such as toxic epidermal necrolysis also reported. A frequently encountered side effect is hand-foot syndrome (palmar-plantar erythrodysesthesia), which is characterized by skin lesions including erythema, edema, blisters, and ulcerations, often accompanied by paresthesia, dysesthesia, or even severe pain. This syndrome significantly compromises patients’ quality of life and interferes with daily activities.