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Definition: Fissures are skin cracks caused by Xerosis in skin areas where the epidermis is thick (tops of fingers or toes, knuckles and nail folds).1 Pain associated with Fissures may be graded.

Incidence: Common.2,3,4,5,6

Onset: Some weeks to months after treatment initiation.7

Resolution: Within 4 weeks of completion of EGFRI treatment.

ICD10 codes:

  • R23.8 Other and unspecified skin changes.
  • Y43.8 Other drugs, medicaments and biological primarily systemic substances causing adverse effects in therapeutic use, not elsewhere classified.

Grade 1

Mild pain.

Typical clinical presentations of grade 1 Fissures can be viewed at the bottom of the page.

Grade 2

Moderate pain; limiting instrumental ADL (refers to preparing meals, shopping for groceries or clothes, using the telephone, managing money etc).

Typical clinical presentations of grade 2 Fissures can be viewed at the bottom of the page.

Grade 3

Severe pain; limiting self care ADL (refers to bathing, dressing and undressing, feeding self, using the toilet, taking medications, and not confined to bed).

Typical clinical presentations of grade 3 Fissures can be viewed at the bottom of the page.

References

1Segaert S & Van Cutsem E. Ann Oncol 2005; 16: 1425-1433.
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.
7Roé E et al. J Am Acad Dermatol 2006; 55: 429-437.

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