General management of skin reactions from cancer treatment in palliative care

Radiotherapy and systemic anticancer drugs (eg cytotoxic chemotherapy, endocrine therapy, biologics, targeted therapies, immunotherapy) can cause skin reactions of varying severity. Management of reactions includes:

• use of general skincare measures
• management of pain and other effects such as itch, dermatitis or acute skin reactions
• treatment of concurrent bacterial or fungal skin infections
• consultation with the patient’s treating oncologist for advice on managing acute skin reactions, and to discuss modifying or stopping cancer treatment
• for severe cases (eg mucosal involvement), seeking expert dermatologist advice, or admission for supportive multidisciplinary management, especially if the patient’s goals of care include prolonging life.

Consider the potential benefits and burdens of each intervention, and the patient’s prognosis, preferences and goals of care—see Principles of symptom management in palliative care.