Childhood cancer survivors can be at risk for developing the following dermatologic late effects:
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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:
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Age at treatment
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Type and total dose of radiation
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Sun exposure
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Tanning booth
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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
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Dermatologic Changes
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Dermatologic Toxicity
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Permanent Alopecia
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Dysplastic Nevi/ Skin Cancer
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Alkylating Agents
Carmustine
BCNU
Busulfan
Lomustine
CCNU
Chlorambucil Cyclophosphamide
Cytoxan
Ifosphamide
Mechlorethamine
Melphalan
Procarbazine
Thiotepa
Dacarbazine
DTIC
Temozolomide
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Heavy Metals
Carboplatin
Cisplatin
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Antimetabolites
Cytarabine
Ara-C
Mercaptopurine
6MP
Thioguanine
6TG
Methotrexate
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Anthracycline antibiotics
Daunorubicin
Doxorubicin
Adriamycin
Epirubicin
Idarubicin
Mitoxantrone
Epipodophyllotoxins
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Chemotherapy
Table 2
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Dermatologic Changes
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Dermatologic Toxicity
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Permanent Alopecia
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Dysplastic Nevi/ Skin Cancer
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Anti-tumor antibiotics
Bleomycin
Dactinomycin
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Corticosteroids
Dexamethasone
Decadron
Prednisone
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Enzymes
Asparaginase
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Plant alkaloids
Vincristine
Vinblastine
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Epipodophyllotoxins
Etoposide
VP16
Teniposide
VM26
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Radiation
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Dermatologic Changes
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Dermatologic Toxicity
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Permanent Alopecia
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Dysplastic Nevi/ Skin Cancer
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All Radiation
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X
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TBI
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X
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Head/Brain
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X
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X
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X
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Neck
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X
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X
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X
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Thorax
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X
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X
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X
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Abdomen
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X
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X
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X
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Pelvis
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X
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X
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X
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Extremity
Epipodophyllotoxins
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X
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X
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X
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Hematopoetic Stem Cell Transplant
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Dermatologic Changes
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Dermatologic Toxicity
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Permanent Alopecia
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Dysplastic Nevi/ Skin Cancer
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Hematopoeitic
Stem Cell Transplant
with any history
of chronic GVHD
Epipodophyllotoxins
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X
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X
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