Think these are the hands of a builder? Wrong!

You could easily be forgiven for assuming these were the overworked hands of a labourer.

Yet the cracks and cuts on this man’s fingers are not the result of grueling manual work. Instead, they were caused by drugs used to treat his cancer. 

And he wasn’t alone, as doctors also documented the tale of a woman with cut-like lesions on her hands, also caused by EGFR inhibitors.

Doctors in California were so intrigued by the side effects of both patients that they published the two tales in the prestigious BMJ Case Reports. 

You could easily be forgiven for assuming these were the overworked hands of a labourer. Yet they are the hands of a cancer patient, who was left with cuts all over his hands because of drugs to treat the disease

Epidermal growth factor receptor (EGFR) inhibitors are doled out to treat several forms of cancer, often alongside chemotherapy.

They are designed to block the protein, found at abnormally high levels in cancer cells, to stop certain tumours from growing. 

Reports have surfaced over the past decade that the drugs can lead to rashes, as patients have complained of breakouts on their faces.

But this is believed to be one of the first times that EGFR inhibitors have been linked to cut-like lesions on fingers and hands.  

Writing in the journal, doctors led by Dr Andrew Iskander said: ‘These agents have been associated with several skin lesions. 

‘We describe a unique toxic effect of these agents involving the fingertips and lateral aspects of fingers in a small patient series.

‘We call for awareness of this unique skin toxicity with the use of EGFR inhibitors in patients with cancer.’  

In the first case, an unidentified 68-year-old man was given a five-month course of one of the drugs to treat his metastasized bowel cancer. 

In the second case, a 61-year-old woman battling lung cancer had complained of cut-like lesions on her fingers after starting a new treatment

In the second case, a 61-year-old woman battling lung cancer had complained of cut-like lesions on her fingers after starting a new treatment

WHAT ARE EGFR INHIBITORS? 

Epidermal growth factor receptor (EGFR) inhibitors are doled out to treat several forms of cancer, often alongside chemotherapy.

They are designed to block the protein, found at abnormally high levels in cancer cells, to stop certain tumours from growing. 

Reports have surfaced over the past decade that the drugs can lead to rashes, as patients have complained of breakouts on their faces.

But this is believed to be one of the first times that EGFR inhibitors have been linked to cut-like lesions on fingers and hands.  

But after just four weeks of taking cetuximab alongside chemotherapy, he became concerned of the ‘painful cuts’ on the tips and sides of his fingers.

The man told doctors in Rancho Mirage, near Palm Springs, that his lesions were causing him ‘significant pain and discomfort’.

Medics decided to stop the man’s treatment of cetuximab, as scans showed his cancer was still rapidly spreading through his body.

The man’s hands quickly improved over the space of a couple of weeks, however, shortly after discontinuing the therapy, he died. 

In the second case, a 61-year-old woman battling lung cancer had complained of cut-like lesions on her fingers after starting a new treatment. 

Doctors gave her osimertinib, an EGFR inhibitor, to combat some of the arising complications of her stage four disease.

But one month in, she returned to oncologists at the Lucy Curci Cancer Center, complaining on cut-like lesions on her fingers.

The woman, who hasn’t been identified, admitted her cuts had began to hinder her usual daily activities and was left in pain.  

Doctors continued her on osimertinib, however, they gave her an oatmeal colloidal solution to treat the lesions.

The solution of oats and water, which binds to skin and forms a protective barrier, has worked but the cuts still cause trouble for the woman.



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