Prevention and basic therapy of skin toxic reactions in children receiving anti-cancer drug therapy. Part 1

Current protocols of anti-cancer therapy in pediatric oncology demonstrate high efficacy, but their application is often accompanied by development of toxic effects. Skin toxic reactions toxicity occupies one of the leading places in the structure of adverse events of drug treatment, significantly affecting the quality of life of patients and limiting the opportunity to carry out anti-cancer therapy at the scheduled doses and time periods. Skin reactions can be caused by a wide range of anti-cancer drugs, including cytostatics (paclitaxel, methotrexate, cytarabine, doxorubicin), targeted (crizotinib, epidermal growth factor receptor (EGFR) inhibitors) and immunotargeted (dinutuximab, etc.) drugs. Acne-like eruptions, hand-foot syndrome, maculopapular rash, alopecia, itching, xerosis as well as rare but potentially life-threatening bullous dermatoses are the most common manifestations. The article presents data on the spectrum and incidence of adverse dermatological reactions in children receiving modern anti-cancer drugs and considers the role of concomitant therapy in the correction of skin toxic reactions. Timely application of accompanying treatment agents allows to minimize skin damage, accelerate restoration of the skin barrier and increase adherence to anti-cancer treatment. Special attention is given to the preventive measures and treatment of dermatological reactions, which helps to prevent their progression and reduce the risk of forced discontinuation or modification of the background therapy.