Clinical Updates

Hydroxyurea: an old drug for new dermatologists

10 August 2010

Sélim Aractingi, MD, PhD

Hydroxyurea, which acts as an antimetabolite and leads to the inhibition of DNA replication, was first launched onto the market in the 1960s. It is now nearly always prescribed for patients with myeloproliferative disease, and rarely those with sickle cell disease or hypereosinophilic syndrome. However, the probability of cutaneous reactions is very high - nearly 100% of HU-treated patients develop such reactions. Although these reactions are usually benign, more severe reactions (eg leg ulcers and skin cancer) can occur, prompting a switch from HU treatment to other drug alternatives. As a result, Dr Aractingi advises that HU-treated patients should have their skin examined yearly after several years of treatment.

Dermatological side-effects of EGFRIs: skin, hair and nails

14 June 2010

Mario E Lacouture, MD

Epidermal growth factor receptor inhibitors (EGFRIs) are a group of drugs used widely against the most frequently fatal cancers, such as lung, colorectal, pancreatic and breast cancers. They are associated with lower rates of systemic and hematopoietic toxicity when compared with conventional cytotoxic chemotherapy but lead to dermatological toxicities (including folliculitis, xerosis, hair changes, and periungual and nail changes) in the majority of patients. Dr Lacouture emphasizes that early evaluation and intervention of such patients is important in order to ensure that they receive life-prolonging therapy. He states that "effective management of these untoward events is critical for the maintenance of patients' quality of life and to achieve the best possible clinical outcome."

HPV vaccines in the prevention of genital warts

14 April 2010

Dany Nassar, MD and Sélim Aractingi, MD

Genital human papillomavirus (HPV) is the most prevalent sexually transmitted disease in the Americas, Australia and Europe, and can either remain as an asymptomatic infection or manifest as external or internal genital warts. In some patients, there is also the risk of developing carcinoma. Two commercially launched vaccines - Gardasil^® (Merck) and Cervarix^® (GlaxoSmithKline) - are now available for the primary prevention of genital HPV infections. Drs. Dany Nassar and Sélim Atactingi comment on the results of recent clinical trials of these vaccines, concluding that the "efficacy of HPV vaccination in preventing the development of uterine cervical cancer is the first successful model of cancer immunoprevention". However, the authors warn that vaccination should not detract from the importance of practicing safe sex to prevent other sexually transmitted diseases.