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Acneiform Rash

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  • Takahashi H, Yaegashi Y, Saito Y, Nihei S, Tairabune T, Ujiie H, Asaka J, Kudo K. Effect of risk factors for acneiform rash induced by anti-epidermal growth factor receptor antibody drugs on survival: a retrospective observational study. J Pharm Health Care Sci. 2022 Sep 1;8(1):22. doi: 10.1186/s40780-022-00253-y. PMID: 36045384; PMCID: PMC9434966.

  • Williams, L. A., Ginex, P. K., Ebanks, G. L., Jr, Ganstwig, K., Ciccolini, K., Kwong, B. K., Robison, J., Shelton, G., Strelo, J., Wiley, K., Maloney, C., Moriarty, K. A., Vrabel, M., & Morgan, R. L. (2020). ONS Guidelines™ for Cancer Treatment-Related Skin Toxicity. Oncology nursing forum, 47(5), 539–556.

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Acneiform rash (also called acne-like rash) looks like acne, with raised red bumps, redness, and irritation.

Our Supplemental Sheet

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ACNEIFORM RASH CANCER TREATMENT EDUCATION Page 1 What is acneiform rash? • Acneiform rash (also called acne-like rash) looks like acne, with raised red bumps, redness, and irritation. • Despite the similar appearance, it should not be treated with acne medications. • It most often occurs on the face, chest, back, arms, and scalp. What should I know about acneiform rash? • It is a common side effect of a type of medication called an EGFR (epidermal growth factor receptor) blocker. • The acne-like rash often starts within the first 2–4 weeks of treatment. • At first it may feel warm, tender, or like a burning sensation. It may then turn red and feel swollen. • Eventually you may experience raised bumps, sometimes called papules or pustules, that crust over and become very dry, itchy, or painful. • Severe acneiform rash may lead to infection if not properly managed. • Your skin may also be more prone to sunburn. • Acneiform rash can change your appearance, which may lead to changes in body image and feeling uncomfortable or depressed. What puts me at risk of experiencing acneiform rash? • Being male may increase the risk for acneiform rash. • The rash is typically worse with higher doses of EGFR blockers. • Developing an acneiform rash may mean that your cancer might respond better to the treatment you are receiving. How is acneiform rash identified/evaluated/diagnosed? • Acneiform rash may present after beginning treatment with an EGFR blocker and may appear as papules and/or pustules. • The acneiform rash may be tender and itchy. What can I do to prevent acneiform rash or manage it once it appears? • Do: • Use a daily moisturizing cream on skin at least 2 times daily. • Use sunscreen of at least SPF 30 when outside and avoid prolonged direct sun exposure. • Gently clean skin with mild soap and warm water and pat to dry. • Ask your care team if they recommend: • An over-the-counter steroid cream to be used on the skin • An antihistamine to help with itching • Avoid: • Long hot showers that can irritate and dry out skin. • Lotions that contain alcohol or fragrance. • Using benzoyl peroxide or retinoid cream because this does not help acneiform rash and may add to the irritation. ACNEIFORM RASH CANCER TREATMENT EDUCATION Page 2 What might my care team provide to help? • To help prevent severe acneiform rash, your care team may prescribe: • Certain antibiotics to take by mouth • Additional topical steroids or antibiotic creams to apply directly to the affected areas of the skin • Before starting treatment with an EGFR blocker, your care team should carefully look over your skin and note any areas that already show any signs of bumps, redness, or tenderness. • At each visit after starting treatment, this should be repeated to note any signs of skin changes. • You should also carefully examine your skin each day to look for early signs of changes. When should I call my care team? • At the first signs of a rash that looks like acne after starting treatment with an EGFR blocker. • If any areas of rash show signs of drainage, pus, or open sores. • If your rash becomes so severe that it limits your ability to do your normal daily activities or sleep at night. • If your rash is causing you to feel depressed. How can I tell if my acneiform rash is getting better? • It may take up to 4 weeks for the rash to improve. Signs of improvement include: • Decreased redness and tenderness. • Bumps start to dry and crust over. • You may still see discoloration where the rash used to be. What questions should I ask my care team about acneiform rash? • Is it helpful for me to track my symptoms? What do you recommend? • Do any of my other medical conditions increase my chance of experiencing acne-like rash? • Do you recommend any changes to my medications to help prevent or control acne-like rash? • What lifestyle changes do you recommend to manage my acne-like rash? • What are my options if acne-like rash cannot be controlled while I am receiving cancer treatment? Where can I find out more information about acneiform rash? Hair, Skin, and Nail Problems | American Cancer Society • Skin Reactions to Targeted Therapy and Immunotherapy | Cancer.Net • skin-reactions-targeted-therapy-and-immunotherapy Skin and Nail Changes During Cancer Treatment | National Cancer Institute • ACNEIFORM RASH CANCER TREATMENT EDUCATION Page 3 Additional instructions Important notice: The Association of Community Cancer Centers (ACCC), Hematology/Oncology Pharmacy Association (HOPA), National Community Oncology Dispensing Association, Inc. (NCODA), and Oncology Nursing Society (ONS) have collaborated in gathering information for and developing this Cancer Treatment Education sheet. This summarized information represents a brief summary of supportive care information and other resources. This Cancer Treatment Education sheet does not cover all existing information related to the possible directions, doses, precautions, interactions, adverse effects, or risks associated with specific medication or adverse events and should not substitute for the advice of a qualified healthcare professional. Provision of this Cancer Treatment Education sheet is for informational purposes only and does not constitute or imply endorsement, recommendation, or favoring of this side effect management by ACCC, HOPA, NCODA, or ONS, who assume no liability for and cannot ensure the accuracy of the information presented. The collaborators are not making any representations with respect to the clinical information presented whatsoever, and any and all decisions, with respect to such patient management, are at the sole risk of the individual consuming the medication. All decisions related to education and managing adverse events should be made with the guidance and under the direction of a qualified healthcare professional. Permission: Cancer Treatment Education sheets are provided as a free educational resource for patients with cancer in need of concise, easy-to-understand information about cancer topics and adverse event management. Healthcare providers are permitted to copy and distribute the sheets to patients as well as direct patients to the Oral Chemotherapy Education (OCE) website for information. However, commercial reproduction or reuse, as well as rebranding or reposting of any type, are strictly prohibited without permission of the copyright holder. Please email permission requests and licensing inquiries to This email address is being protected from spambots. You need JavaScript enabled to view it.. Copyright © 2023 by NCODA. All rights reserved.

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