Assoc. Prof. Dr. Razvigor Darlenski
Acibadem Cityclinic Tokuda Hospital Sofia Bulgaria
Dermatologic adverse effect to targeted and immunotherapy of cancer
Autor: Assoc. Prof. Dr. Razvigor Darlenski
The wide variety of drug-induced dermatoses requires deep knowledge in this specific field.The latest clinical researches has discovered important facts about classification, pathogenesis and therapeutic approaches in toxic skin reactions due to target treatment. Although dermatologic toxicities with systemic cancer therapies are very frequent, a minority of cancer patients visit a dermatologist during their therapy.
Usually the dermatologic toxicities include impairment of the skin, oral mucosa, hair, and nails. The most common adverse reaction is acneiform rash, which is observed in 25–85% of patients treated by epidermal growth factor receptor and mitogen-activated protein kinase kinase inhibitors. BRAF inhibitors most often lead to hyperkeratotic skin reactions like hand-foot skin reaction or palmoplantar keratoderma, squamous cell carcinoma, keratoacanthomas and maculopapular hypersensitivity-like rash. Immune checkpoint inhibitors most frequently induce nonspecific maculopapular rash, but also eczema-like or psoriatic lesions, lichenoid reactions, xerosis cutis, and pruritus. mTOR inhibitors very often are responsible for the oral mucosal toxicities like mucositis and stomatitis, followed by stomatitis associated with multikinase angiogenesis and HER inhibitors. Targeted therapies and endocrine therapy also commonly induce alopecia,vitiligo, bullous dermatoses etc. Finally, targeted therapies may damage nail folds, with paronychia and periungual pyogenic granuloma distinct from chemotherapy-induced lesions.
It’s important not only to understand the etiopathogenesis but also to establish universal treatment guidelines, that can be used by dermatologists, oncologists, radiologists, dental specialists etc. The multidisciplinary approach is the most important way to achieve higher quality of life in those patients.
Razvigor Darlenski is a dermatologist coming from Bulgaria. In 2014 he was selected as an associate professor at Trakia University, Stara Zagora. In 2010 he has defended a PhD thesis on the role of epidermal barrier for skin irritation and sensitization. Currently he is working as dermatologist at Tokuda Hospital Sofia, Bulgaria. Dr. Darlenski has published more than 70 papers in peer-reviewed journal and he is also an author of 12 book chapters. Dr. Darlenski is a member of the following organizations: Bulgarian Dermatological Society (BDS), member of the Honours & Awards committee of the European Academy of Dermatology and Venereology, Junior working group of the World Allergy Organization, European Academy of Allergology and Clinical Immunology, European Epidermal Barrier Research Network, European Network for Cutaneous Adverse Effects of Drugs (ENCAD), European Surveillance System on Contact Allergies, Union of Scientist in Bulgaria, Bulgarian Allergology Society, Bulgarian Medical Association, National Bulgarian Society of Aesthetic Surgery and Aesthetic Medicine, International society of skin physiology and pharmacology (ISP).
He is a winner of several awards among which Inaugural Edward L. Keyes award of the IACD for this meeting in Cancun (2012), Winner of the EER fellow award of the ESDR and ASDV (2013), Michael Hornsetin Memorial Scholarship of the EADV (2009).
His research interests are focused on skin barrier, drug reactions of the skin, skin irritation, contact allergy, urticaria, atopic eczema, and non-invasive methods in dermatology.