Dr. Cerbu Anca

Dr. Cerbu Anca
Dermaclas Clinic / Laurus Medical Bacău, Romania

Eritrodisestezia palmo-plantara – efect advers al unor agenti chimioterapici
Autor: Anca Cerbu

Dermaclas Clinic / Laurus Medical Bacau, Romania

Cuvinte cheie: Eritem acral, eritem toxic, chimioterapie, calitatea vietii

Eritrodisestezia palmo-plantara cunoscuta si sub denumirea de eritem acral, eritem toxic palmo-plantar sau sindrom mana-picior chimio-indus se poate manifesta pe parcursul chimioterapiei pentru diverse forme de neoplazii. Printre agentii chimioterapici incriminati in declansarea sa, mentionam 5 Fluoro-Uracil, capecitabina, doxorubicina lipozomala pegilata, docetaxel, citarabina, vinorelbina, fiind raportate cazuri si dupa utilizarea hidroxiureei, metotrexatului. Clinic manifestarile apar de obicei dupa prima doza administrata, intensificandu-se ulterior la urmatoarele doze. Sunt afectate intai palmele, apoi talpile, mai rar fata dorsala a mainilor si antepiciorul. Debutul este prin disestezii, eventual cu un usor eritem.Ulterior eritemul se intensifica, asociat cu edem, pot aparea vezicule, descuamare, chiar ulceratii, insotite de durere intensa, cu impact puternic asupra calitatii vietii. Tratamentul consta in managementul reactiei locale si la nevoie ajustarea dozelor ulterioare de agent chimioterapic daca se impune. Prezentam cazul unei paciente de 66 de ani diagnosticata in urma cu 4 ani cu neoplasm mamar stang operat, la care s-a initiat chimioterapie cu docetaxel. Dupa prima sedinta pacienta acuza disestezii si discret eritem palmar. Dupa secventa a 2a de tratament se prezinta la consult dermatologic pentru intensificarea placardelor eritematoase, vezicule si descuamare, insotite de durere, inclusiv dureri la nivelul unghiilor. Pacientei i s-a explicat ca este un efect advers al docetaxelului si ca dupa fiecare sedinta din cele 4 totale recomandate, leziunile se pot agrava. Sub tratamentul local propus evolutia a fost favorabila. Concluzionam subliniind necesitatea recunoasterii de catre dermatolog a acestor reactii pentru a evita supradiagnosticarea altor patologii si importanta educarii pacientului de catre medicul oncolog, cu expunerea posibilelor reactii ce pot surveni si raportarea acestora cat mai repede.

Palmo-plantar erythrodysaesthesia – a side effect of various chemotherapeutic drugs
Author: Anca Cerbu

Dermaclas Clinic / Laurus Medical Bacau, Romania

Key words: Acral erythema, toxic erythema, chemotherapy, quality of life

Palmo-plantar erythrodysaesthesia also known as acral erythema, toxic erythema or chemotherapy induced hand-foot syndrome may follow many chemotherapy drugs for various types of neoplasm. The most involved agents are 5-Fluorouracil, capecitabine, pegylated liposomal doxorubicin, docetaxel, cytarabine, vinorelbine, even hydroxyurea or methotrexate. Frequently the clinical features appear within days of starting chemotherapy, being dose related afterwards. First involved are the palms, then the soles of the feet and less consistently the back of the hands and tops of the feet, with dysesthesia and erythema, oedema, sometimes vesicles, desquamation, even ulceration and intense pain, with a great impact on the quality of life. Treatment consists of managing the local reaction and lowering the chemotherapeutic dose when needed. We present the case of a 66 years old woman diagnosed with mammary neoplasm 4 years ago, who underwent surgery and now begun chemotherapy with docetaxel. After the first session the patient accused dysaesthesia and a discrete palmar erythema. After the second session of treatment she requests a dermatology consultation because of the intensification of the erythematous plaques, vesicles and desquamation and painful nails. It was explained to the patient that this was an adverse effect of docetaxel and after every drug session the lesions may worsen. Under the local treatment the outcome was favorable. We conclude by emphasising the necessity of disease recognition by the dermatologist to avoid overdiagnostication and the importance of patient education regarding these adverse effects by the oncologist so they may report it as soon as it develops.

Scurt CV

STUDII
2003- 2009 Facultatea de Medicina Generala, UMF “Grigore. T. Popa” Iasi, Romania
2007 – 2008 Bursa Erasmus “Universita di Medicina e Chirurgia”, Torino, Italia
1999 – 2003 Colegiul National “Emil Racovita”, profil matematica-informatica, intensiv engleza, Iasi, Romania
EXPERIENTA
Februarie 2017 – prezent – medic specialist Dermato-venerologie domeniul privat Bacau (Dermacenter, Dermaclas Clinic, Laurus Medical)
ianuarie 2010 – ianuarie 2017 Spitalul Clinic de Urgenta “Sf. Spiridon” Iasi, Romania
EDUCATIE SI TRAINING
Multiple burse de studiu ale Academiei Europene de Dermatologie (EADV)
Mai 2017 Bruxelles, Belgia Curs Master Class EADV – “Boli ale parului si scalpului”,
Noiembrie 2016 Amsterdam, Olanda Curs avansat EADV – “Boli cu transmitere sexuala”,
Octombrie 2016 Viena, Austria Workshop în cadrul Congresului European de Dermatologie EADV – “Boli cu transmitere sexuala”,
Iulie 2016 Viena, Austria Workshop EADV/ ESDR – “Cercetare si tehnici de imagistica: structura pielii, functiile acesteia si procesul de homeostazie”
Iunie 2016 Bruxelles, Belgia Curs EADV– “Managementul ulceratiilor cronice si Telemedicina”,
Februarie 2016 Dessau, Germania Curs EADV– “Hidradenita supurativa/acne inversa”,
Mai 2016 Atena, Grecia Master Class EADV – “Imagistica tegumentului”,
June 2015 Zagreb, Croatia Curs EADV– “Dermatoscopie”,
Cursuri post-universitare
Iunie 2017 Curs post-universitar – “Dermatoscopie”, UMF Cluj-Napoca, Romania
Februarie – Aprilie 2016 Iasi, Romania Curs post-universitar – “Capilaroscopie” UMF “Grigore. T. Popa”
Iunie – Septembrie 2014 Curs post-universitar “Dermatologie pediatrica”, UMF “Grigore. T. Popa” Iasi, Romania
Martie 2011 Curs de chimioterapie dermato-oncologica “Rolul chimioterapiei în tratamentul tumorilor cutanate”
UMF “Grigore. T. Popa” Iasi, Romania
Articole publicate
1. Anca Cretu, E. Crihan, A. Oanta, C. Salavastru, D. Branisteanu, D.E. Branisteanu – “Napkin Psoriasis – case report” Rev Med Chir Soc Med Nat Iasi. 2014 Oct-Dec;118(4):1008-12. ( CNCSIS B+)
2. Anca Cretu, A. Dimitriu, D. Branisteanu, D.E. Branisteanu – “Erythema multiforme – etiopathogenic, clinical and therapeutic aspects” Rev Med Chir Soc Med Nat Iasi, 2015 Jan-Mar; 119 (1): 55-61. ( CNCSIS B+)
3. D.E.Branisteanu, C. Voicu, Anca Cretu, A.Dimitriu, M.C. Luca, C. Salavastru – “Adverse reactions of biological therapy for psoriasis” Rev Med Chir Soc Med Nat Iasi, 2015 Jan-Mar; 119 (1): 38-44. ( CNCSIS B+)
4. Anca Cretu, A.R. Luca, D.E. Branisteanu – “Scleroderma – clinical, laboratory and therapeutic aspects” Dermatovenerologie – Rev Soc Rom de Derm (Romanian Society of Dermatology – SRD Journal) 2015 vol. 60, nr.4, p. 239-247 ( ISSN 1220/3734)

Membra a EADV, IDS (International Dermoscopy Society), ESPD (European Society of Pediatric Dermatology), SRD (Societatea Romana de Dermatologie)