Childhood cancer survivors can be at risk for developing the following dermatologic late effects:
·
Dermatologic Changes
o
Fibrosis
o
Telangiectasias
o
Altered Skin Pigementation
·
Dermatologic Toxicity
o
Nail Dysplasia
o
Vitiligo
o
Scleroderma
·
Permanent Alopecia
·
Dysplastic Nevi/Skin Cancer
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If your patient does not have a Survivor Health Plan (SHP), please refer him/her to the appropriate survivor clinic.
Important factors in determining risk for dermatologic late effects:
-
Age at treatment
-
Type and total dose of radiation
-
Sun exposure
-
Tanning booth
-
Gorlins’ syndrome
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For recommendations on how to screen for all potential late effects, please refer to The Children’s Oncology Group Long-Term Follow-Up Guidelines.
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Chemotherapy
Table 1
|
Dermatologic Changes
|
Dermatologic Toxicity
|
Permanent Alopecia
|
Dysplastic Nevi/ Skin Cancer
|
Alkylating Agents
Carmustine
BCNU
Busulfan
Lomustine
CCNU
Chlorambucil Cyclophosphamide
Cytoxan
Ifosphamide
Mechlorethamine
Melphalan
Procarbazine
Thiotepa
Dacarbazine
DTIC
Temozolomide
|
|
|
|
|
Heavy Metals
Carboplatin
Cisplatin
|
|
|
|
|
Antimetabolites
Cytarabine
Ara-C
Mercaptopurine
6MP
Thioguanine
6TG
Methotrexate
|
|
|
|
|
Anthracycline antibiotics
Daunorubicin
Doxorubicin
Adriamycin
Epirubicin
Idarubicin
Mitoxantrone
Epipodophyllotoxins
|
|
|
|
|
Chemotherapy
Table 2
|
Dermatologic Changes
|
Dermatologic Toxicity
|
Permanent Alopecia
|
Dysplastic Nevi/ Skin Cancer
|
Anti-tumor antibiotics
Bleomycin
Dactinomycin
|
|
|
|
|
Corticosteroids
Dexamethasone
Decadron
Prednisone
|
|
|
|
|
Enzymes
Asparaginase
|
|
|
|
|
Plant alkaloids
Vincristine
Vinblastine
|
|
|
|
|
Epipodophyllotoxins
Etoposide
VP16
Teniposide
VM26
|
|
|
|
|
Radiation
|
Dermatologic Changes
|
Dermatologic Toxicity
|
Permanent Alopecia
|
Dysplastic Nevi/ Skin Cancer
|
All Radiation
|
|
|
|
X
|
TBI
|
|
|
|
X
|
Head/Brain
|
X
|
|
X
|
X
|
Neck
|
X
|
|
X
|
X
|
Thorax
|
X
|
|
X
|
X
|
Abdomen
|
X
|
|
X
|
X
|
Pelvis
|
X
|
|
X
|
X
|
Extremity
Epipodophyllotoxins
|
X
|
|
X
|
X
|
Hematopoetic Stem Cell Transplant
|
Dermatologic Changes
|
Dermatologic Toxicity
|
Permanent Alopecia
|
Dysplastic Nevi/ Skin Cancer
|
Hematopoeitic
Stem Cell Transplant
with any history
of chronic GVHD
Epipodophyllotoxins
|
|
X
|
X
|
|
|