Mucosal Changes

In addition to dry skin, dryness of the mucosae (eyes, vagina, mouth or nose) may also occur in EGFRI-treated patients.^1,2,3

Furthermore, conjunctivitis can be seen, either due to dryness (Xerophthalmia) or to mechanical irritation by trichomegalic eyelashes (conjunctivitis).² Dry mouth, Aphthous stomatitis or a geographic tongue may be encountered in the oral mucosa.^3,4 The genitalia are occasionally involved with dry vulvovaginitis (especially in postmenopausal women) or Balanitis.⁵

Incidence: Common.^6,7,8,9,10

Onset: Some weeks to months after treatment initiation.

Resolution: Some weeks following completion of EGFRI treatment.

Conjunctivitis and Blepharitis

ICD10 codes:    

• Y43.8 Other drugs, medicaments and biologicals, primarily systemic substances causing adverse effects in therapeutic use, not elsewhere classified.
• H10.9 Conjunctivitis, unspecified.
• H19.3 Keratoconjunctivitis sicca.

Typical clinical presentations of conjunctivitis and Blepharitis can be viewed at the bottom of the page.

Vulvitis

ICD10 code:

• N76.8 Other specified inflammation of vagina and vulva.

Typical clinical presentation of vulvitis can be viewed at the bottom of the page.

Balanitis

ICD10 code:

• N51.2 Balanitis in diseases classified elsewhere  

Typical clinical presentation of Balanitis can be viewed at the bottom of the page.

Oral mucositis

ICD10 code:

• K91.8 Other postprocedural disorders of digestive system, not elsewhere classified.

Typical clinical presentation of oral mucositis can be viewed at the bottom of the page.

References

¹Segaert S & Van Cutsem E. Ann Oncol 2005; 16: 1425-1433.
²Melichar B & Nemcová I. Eur J Cancer Care (Engl) 2007; 16: 439-443.
³Busam KJ et al. Br J Dermatol 2001; 144: 1169-1176.
⁴Segaert S & Van Cutsem E. Oncology (Williston Park) 2007; 21: 22-26.
⁵Segaert S et al. Eur J Cancer 2009; 45(Suppl 1): 295-308.
⁶European Medicine Agency. Tarceva® (erlotinib) Summary of Product Characteristics 2009.
⁷European Medicine Agency. Iressa® (gefitinib) Summary of Product Characteristics 2009.
⁸European Medicine Agency. Erbitux® (cetuximab) Summary of Product Characteristics 2009.
⁹European Medicine Agency. Vectibix® (panitumumab) Summary of Product Characteristics 2009.
¹⁰European Medicine Agency. Tyverb® (lapatinib) Summary of Product Characteristics 2010.