General Recommendations

Due to pain, Fissures may immediately impact on ADL. Therefore, early intervention is important: treatment of areas of dry and cracked skin may help to mitigate lesion severity and progression.

Treatment

  • Grade 1: topical moisturising ointment, salicylic acid ointment, propylene glycol solution.
  • Grade 2: liquid bandages, hydrocolloid dressing, analgesics if clinically appropriate.
  • Grade 3: liquid bandages; hydrocolloid dressing, analgesics if clinically appropriate; consider oral antibiotics when superinfection with Staphylococcus aureus is noted.1

Products

  • Moisturising ointment.
  • Salicylic acid 10% in petrolatum.
  • Propylene glycol 50% in water.
  • Liquid bandages.
  • Hydrocolloid dressing.
  • Flucloxacillin 500 mg tid.
  • Cefuroxime axetil 500 mg bid.

EGFRI Treatment

Continue with the selected EGFRI-treatment regimen if adverse events are graded 1 or 2; withhold EGFRI treatment in cases of grade 3 toxicity; continue with the selected EGFRI-treatment regimen only if toxicity mitigates to grade ≤2. Continue with/withold the selected EGFRI-treatment regimen, as recommended in the current and relevant SmPC and according to the patient’s condition.2,3,4,5,6

References

1Segaert S et al. Eur J Cancer 2009; 45(Suppl 1): 295-308.
2European Medicine Agency. Tarceva® (erlotinib) Summary of Product Characteristics 2009.
3European Medicine Agency. Iressa® (gefitinib) Summary of Product Characteristics 2009.
4European Medicine Agency. Erbitux® (cetuximab) Summary of Product Characteristics 2009.
5European Medicine Agency. Vectibix® (panitumumab) Summary of Product Characteristics 2009.
6European Medicine Agency. Tyverb® (lapatinib) Summary of Product Characteristics 2010.

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