MUCOCUTANEOUS MANIFESTATIONS FOLLOWING CHEMOTHERAPY IN PEDIATRIC MALIGNANCIES
Abstract
ABSTRACT
Objective: Chemotherapy causes destruction of neoplastic cells and rapidly proliferative normal cells leading to significant mucocutaneous changes.
The aim of the present study was to determine the postchemotherapeutic mucocutaneous manifestations in pediatric malignancies.
Methods: In this cross-sectional study, 63 children with malignancy undergoing chemotherapy over 2½ years were examined carefully and followed
up for 6 months. A comprehensive clinical history was taken. Detailed systemic and dermatological examination was carried out in the subjects at the
time of enrollment. Dermatological examination was performed subsequently at 3-6 months and whenever child presented with any symptoms to the
outpatient department. The chemotherapy-induced alopecia (CIA) and pigmentary changes of skin and nails were graded using OSLEN CIA, National
Cancer Institute pigment changes and nail changes' grading scales.
Results: Males (41 [65%]) outnumbered females (1.8:1). Acute lymphoblastic and myelogenous leukemia were noticed in 38 (60.3%) and 8 (12.6%)
patients, respectively. Alopecia (43 [68.3%]) was common with predominant grade 3 (22 [34.92%]). Hair regrowth was noticed in 53 (83.7%)
patients within 6 months. Cutaneous linear pigmentary lines, ichthyosis, acral pigmentation, skin peeling, and mucositis were observed in 13 (21%),
10 (16%), 10 (16%), 7 (11%), and 9 (14.28%) patients, respectively. Among total 56 cutaneous infectious manifestations, viral infections include 4
cases of Herpes Zoster, single case of extensive molluscum contagiosum and Varicella. Tinea faciei was recurrent and poorly responsive to treatment.
The common nail changes noted were Muehrcke's lines and melanonychia (26 [41.26%]).
Conclusion: Alopecia in 43 (68.3%) patients though distressing was reversible in 53 (83.7%) patients. Infections were extensive, recurrent, and
required aggressive treatment.
Keywords: Chemotherapy, Pediatric malignancies, Cancer.
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REFERENCES
Terracini B. Epidemiology of childhood cancer. Environ Health
;10 Suppl 1:S8.
Death registrations in England and Wales: Causes. Health Stat Q
;62-9.
Arora RS, Eden TO, Kapoor G. Epidemiology of childhood cancer in
India. Indian J Cancer 2009;46(1):264-73.
MacDonald T. A comprehensive review. Part I: Biology, epidemiology,
common tumours, principles of treatment and late effects. Can Pharm J
;143:176-83.
Dang-Tan T, Franco EL. Diagnosis delays in childhood cancer: A
review. Cancer 2007;110(4):703-13.
Wyatt AJ, Leonard GD, Sachs DL. Cutaneous reactions to chemotherapy
and their management. Am J Clin Dermatol 2006;7(7):45-63.
Sanches Junior JA, Brandt HR, Moure ER, Pereira GL, Criado PR.
Adverse mucocutaneous reactions to chemotherapeutic agents: Part I.
An Bras Dermatol 2010;85(3):425-37.
Trüeb RM. Chemotherapy-induced hair loss. Skin Therapy Lett
;15(1):5-7.
Cardoza-Torres MA, Liy-Wong C, Welsh O, Gómez-Flores M, OcampoCandiani
J,
González-Llano O,
et
al.
Skin manifestations
associated
with
chemotherapy in children with hematologic malignancies.
Pediatr
Dermatol
;29(2):264-9.
Kamil N, Kamil S, Ahmed SP, Ashraf R, Khurram M, Ali MO.
Toxic effects of multiple anticancer drugs on skin. Pak J Pharm Sci
;23(1):7-14.
Chen W, Yu YS, Liu YH, Sheen JM, Hsiao CC. Nail changes associated
with chemotherapy in children. J Eur Acad Dermatol Venereol
;21:186-90.
Fabbrocini G, Cameli N, Romano MC, Mariano M, Panariello L,
Bianca D, et al. Chemotherapy and skin reactions. J Exp Clin Cancer
Res 2012;31(1):50.
Criado PR, Brandt HR, Moure ER, Pereira GL, Sanches Júnior JA.
Adverse mucocutaneous reactions related to chemotherapeutic agents:
Part II. An Bras Dermatol 2010;85:591-608.
Olsen EA. Chemotherapy-induced alopecia: Overview and methodology
for characterizing hair changes and regrowth. In: Oliver I, editor. The
MASCC Textbook of Cancer Supportive Care and Survivorship.
New York: Springer; 2011. p. 381-8.
Perry MC. The Text Chemotherapy Source Book. 4
ed. Philadelphia,
PA: Lippincott’s Williams and Wilkins; 2008.
th
Yeole BB, Advani SH, Sunny L. Epidemiological features of childhood
cancers in greater Mumbai. Indian Pediatr 2001;38(11):1270-7.
Jignasa BN, Mandakini PM. Profile of pediatric malignancy: A three
year study. Natl J Community Med 2011;2:24-7.
Kusumakumary P, Jacob R, Jothirmayi R, Nair MK. Profile of pediatric
malignancies: A ten year study. Indian Pediatr 2000;37:1234-8.
Gurney JG, Severson RK, Davis S, Robison LL. Incidence of cancer in
children in the United States. Sex-, race-, and 1-year age-specific rates
by histologic type. Cancer 1995;75(8):2186-95.
Dorr VJ. A practitioner’s guide to cancer-related alopecia. Semin Oncol
;25(5):562-70.
Tallon B, Blanchard E, Goldberg LJ. Permanent chemotherapy-induced
alopecia: Case report and review of the literature. J Am Acad Dermatol
;63(2):333-6.
Karthikeyan K, Thappa DM, Jeevankumar B. Pattern of pediatric
dermatoses in a referral center in South India. Indian Pediatr
;41(4):373-7.
Banerjee S, Gangopadhyay DN, Jana S, Chanda M. Seasonal variation
in pediatric dermatoses. Indian J Dermatol 2010;55(1):44-6.
Matthews SN, Cockerell CJ. Prurigo nodularis in HIV-infected
individuals. Int J Dermatol 1998;37(6):401-9.
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