Russian Journal of Skin and Venereal DiseasesRussian Journal of Skin and Venereal Diseases1560-95882412-9097Eco-Vector11226810.17816/dv112268Research ArticleEvaluation of effectiveness of combined supportive treatment for paronychia and pyogenic granulomas, associated with targeted anticancer therapyPolonskaiaAleksandra S.<p>Assistant Lecturer</p>dr.polonskaia@gmail.comhttps://orcid.org/0000-0001-6888-4760ShatokhinaEvgeniya A.<p>MD, Dr. Sci. (Med.), Professor, Senior Research Associate</p>e.a.shatokhina@gmail.comhttps://orcid.org/0000-0002-0238-6563KruglovaLarisa S.<p>MD, Dr. Sci. (Med.), Professor</p>kruglovals@mail.ruhttps://orcid.org/0000-0002-5044-5265Central State Medical Academy of Department of Presidential AffairsLomonosov Moscow State University, Medical Scientific and Educational Center1702202325641530111202207012023Copyright © 2023, Eco-Vector2023<p><strong><em>BACKGROUND:</em></strong> Paronychia and pyogenic granulomas occur in 1050% of patients treated with epidermal growth receptor (EGFR) inhibitors. Supportive therapy for periungual lesions is challenging, since these adverse reactions are prone to torpidity and frequent relapses.</p>
<p><strong><em>AIM:</em></strong> to evaluate the effectiveness of supportive treatment for paronychia and pyogenic granulomas ― dermatologic adverse events of EGFR inhibitors, with a combined cream with betamethasone dipropionate, clotrimazole, gentamicin, and betaxolol solution.</p>
<p><strong><em>MATERIALS AND METHODS:</em></strong> 16 patients with paronychia and pyogenic granulomas associated with EGFR inhibitor therapy were included in a 12-week open-label prospective study. Paronychia and pyogenic granulomas severity assessment was performed with the NCI-CTCAE v. 5.0, a developed 10-point scale. The intensity of pain was assessed with a visual-analogue scale (VAS). The quality of life was assessed with the Dermatology Life Quality Index (DLQI).</p>
<p><strong><em>RESULTS:</em></strong> A significant improvement of all parameters (<em>p</em> 0.05) was evaluated from week 1, indicating the effective reduction of dermatologic adverse event objective and subjective symptoms, improvement of patients quality of life. By the end of the study, 37.5% of patients had complete resolution of lesions, 62.5% of patients had minimal residual erythema. Decrease of pain sensation in the affected periungual folds was observed throughout the study (<em>p</em> 0.05). DLQI score indicated the "small effect" of paronychia and pyogenic granulomas on patients life by the end of the study.</p>
<p><strong><em>CONCLUSIONS:</em></strong> Supportive treatment of paronychia and pyogenic granulomas with a combined cream with betamethasone dipropionate, clotrimazole and gentamicin and a betaxolol 0.25% solution is effective in the management of paronychia and pyogenic granulomas objective and subjective symptoms, has a high tolerability, allows to improve patients quality of life and continue targeted therapy without dose reduction. Long-term maintenance of pain sensation after paronychia and pyogenic granulomas resolution underlines the need for additional treatment options that will improve the effectiveness of pain management.</p>dermatologic adverse eventstargeted cancer therapyparonychiapyogenic granulomassupportive careEGFR inhibitorsдерматологические нежелательные явлениятаргетная противоопухолевая терапияпаронихиипиогенные гранулёмыподдерживающая терапияингибиторы EGFR[Bolotina LV, Vladimirova LY, Dengina NV, et al. 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