Acneiform

ADCC. Cetuximab is approved for treatment of metastatic colorectal cancer (CRC) and squamous cell carcinoma of the head and neck (SCCHN). Interestingly, an adverse event, acneiform rash seems to correlate with a better response to cetuximab, while there is no such correlation with expression levels of EGFR assessed by immunohistochemistry. Further side effects are rare infusion reactions and hypomagnesia. Two other anti-EGFR antibodies approved for clinical use are the fully human antibody panitumumab (Vectibix)... 

Impaired wound healing, thin fragile skin, petechiae, ecchymoses, erythema, increased sweating, suppression of skin test reactions, subcutaneous fat atrophy purpura, striae, hyperpig mentation, hirsutism, acneiform eruptions, urticaria, angioneurotic edema... 

Acneiform eruption after deep chemical peel is a common phenomenon appearing immediately after reepithelialization. Its etiology is multifactorial and is related to either exacerbation of previously existing acne or is due to over-greasing of newly formed skin. Short-term systemic antibiotics together with discontinuation of any oily preparations will usually provide satisfactory solution. 

Cetuximab plus irinotecan Continue irinotecan as previously dosed, plus cetuximab 400 mg/m2 IV loading dose, then cetuximab 250 mg/m2 Asthenia, diarrhea, nausea, acneiform rash,... 

Bosch Garcia, R.J., Gallardo, M.A. and Herrera Ceballos, E. (2001) Acneiform eruption caused by amineptine. A case report and review of the literature. Journal of the European Academy of Dermatology and Venereology, 15, 337-339. 

Adverse reactions may include acneiform eruptions allergic dermatitis arthropathy multiple cases of cholestatic and fulminant hepatitis drowsiness fatigue headache hepatotoxicity resembling viral or alcoholic hepatitis impotence metallic or garlic-like aftertaste peripheral neuropathy polyneuritis optic or retrobulbar neuritis restlessness occasional skin eruptions. 

Adverse events are rare and mostly allergic reactions such as urticaria and acneiform eruptions that probably can be attributed to impurities and preservatives in the preparations. 

Cetuximab has modest activity in relapsed colorectal cancer as a single agent but is more effective with irinotecan and possibly oxaliplatin based regimens where a doubling of the response rate has been observed. There is some evidence that cetuximab may reverse irinotecan resistance. Toxic effects of cetuximab include hypersensitivity reactions, malaise, nausea, headache and an acneiform rash. 

Iodides should not be used alone since the normal gland will escape from iodide blockade in 2-8 weeks. Chronic use in pregnancy is not recommended because it crosses placenta and cause fetal goitre. Iodide treatment results in high intrathyroidal iodide content that can delay the onset of thioamide therapy or delay the use for radioactive iodine therapy for weeks if not months. Adverse effects include Hodism which is rare and reversible. The clinical symptoms are acneiform rash, sialadenitis, mucous membrane ulceration, conjuctivitis, rhinor-rhoea, metallic taste and rarely anaphylactoid reaction. 

Dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral... 

Early in the course of lithium therapy, exacerbations of psoriasis and acneiform eruptions as well as other skin reactions may occur. Possible mechanisms have included lithium s ability to decrease cAMP as well as to increase the number and activity of polymorphonuclear leukocytes. Those with a predisposition to skin disorders are most at risk for this complication, with women more likely than men to experience a dermatological reaction to lithium. These problems may clear spontaneously or may require lithium dose reduction, appropriate dermatological intervention, or lithium discontinuation ( 77). 

Transient acneiform eruptions have been noted early in lithium treatment. Some of them subside with temporary discontinuance of treatment and do not recur with its resumption. Folliculitis is less dramatic and probably occurs more frequently. Leukocytosis is always present during lithium treatment, probably reflecting a direct effect on leukopoiesis rather than mobilization from the marginal pool. This adverse effect has now become a therapeutic effect in patients with low leukocyte counts. 

Adverse reactions to iodine (iodism) are uncommon and in most cases reversible upon discontinuance. They include acneiform rash (similar to that of bromism), swollen salivary glands, mucous membrane ulcerations, conjunctivitis, rhinorrhea, drug fever, metallic taste, bleeding disorders and, rarely, anaphylactoid reactions. 

Iododerma, which is thought to be an allergic reaction, starts with an acneiform lesion, localized in the area of the sebaceous glands, which spreads to form verrucous granulomatous lesions (61,62). After discontinuation of iodide, the skin clears over a few weeks. In addition to this typical picture of iodide sensitivity, iodide can cause urticaria and erythema and even hemorrhagic rashes. In order to verify the etiology of the skin conditions in certain cases, sensitivity testing may be required, but is not without risk. 

Discharges from the acneiform eruptions of two patients analyzed at 32 and 45 ppm PCBs. An 18 year old male showed ca. 75 and 13 ppm in subcutaneous fat samples taken from his face and abdomen, respectively. GLC patterns similar to those in contaminated rice oils were found in the human samples examined, including those from fetal and placental tissues. Tissues from a stillborn infant (October 1968) were preserved for later analysis. These had PCB concentrations in liver, skin and fat of 1.8, 1.2 and 0.1 ppm, respectively. The pregnant mother had been diagnosed as a severe case of Yusho. First trimester PCB concentrations reported for 19 embryos were low (<2ppb). Second and third trimester were successively higher (Table 9) ... 

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